Derm

Question 1

Vitiligo- associated conditions?

Answer 1

type 1 diabetes mellitus
Addison’s disease
autoimmune thyroid disorders
pernicious anaemia
alopecia areata

Question 2

Scarring vs non-scarring alopecia?

Answer 2

Question 3

itchy papular rash on her palms, extending onto the flexor aspect of the forearms.
White lines are visible across the surface of the rash.

what is it? tx?

Answer 3

lichen planus
purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham’s striae over surface.

potent topical steroids are the mainstay of treatment

think !!! -lichen sclerosus: itchy white spots typically seen on the vulva of elderly women

Question 4

hair loss following stressful period e.g. surgery?

Answer 4

Telogen effluvium is the loss and thinning of hair in response to severe stress

Question 5

severe acne: predominantly papular/pustular with nodules and scarring.
tx?

Answer 5

oral abx (tetracycline, oxytetracycline, doxycycline, or lymecycline ) and topical benzoyl peroxide

Question 6

Answer 6

Hereditary haemorrhagic telangiectasia

Question 7

describes features of Basal cell carcinoma?

Answer 7

rolled, pearly edges with telangiectasia on the inferior border of the lesion

Question 8

Psoriasis: management

Answer 8

Topical steroid + topical calcipotriol

Question 9

Rosacea (sometimes referred to as acne rosacea) presentation and tx (mild vs moderate)?

Answer 9

Question 10

Erythema nodosum causes:
infection?
systemic?
drugs?

Answer 10

think CARBAMAZEPINE

Question 11

Drugs cause this?

Answer 11

erythema multiforme

Question 12

Squamous cell carcinoma most common risk factors?

Answer 12

Question 13

Dermatitis herpetiformis

explain rash?
pathophysiological process

Answer 13

formation of IgA antibodies

Question 14

Zinc deficiency features?

Answer 14

Question 15

name a rash that develop acutely over several days 1-2 weeks after a streptococcal infection

(this patient has just had bacterial tonsillitis, which is typically caused by group A streptococcus infection).

Answer 15

GUTTATE PSORIASIS

Teardrop

Question 16

Keratoacanthoma dx via GP

mx

Answer 16

urgent derm referral

Question 17

narrowband ultraviolet B light and psoralen + ultraviolet A light (PUVA) used in secondary care mx for psoriasis- ADVERSE EFFECT?

Answer 17

Question 18

3-year-old son who suffers from eczema
eczema has become a lot worse this week
He has developed widespread itchy blisters all over his body: including his face, torso, arms and legs.

dx? tx?

Answer 18

Eczema herpeticum is a serious condition that requires IV antivirals

Question 19

26-year-old woman presents with a recurrent, intensely itchy rash on the palms of her hands.

they tend to occur every summer.

Answer 19

Pompholyx eczema may be precipitated by humidity (e.g. sweating) and high temperatures

Question 20

three-week history of an itchy rash over the face and upper chest

PMx: HIV for which he is poorly compliant

rash? tx

Answer 20

Seborrhoeic dermatitis - first-line treatment is topical ketoconazole

Question 21

Answer 21

Question 22

Answer 22

Question 23

stress ulcer that can occur after severe burns?

stress ulcer that occurs in the aftermath of severe head trauma.

Answer 23

Curling’s ulcer is a stress ulcer that can occur after severe burns

Cushing’s ulcer is a stress ulcer that occurs in the aftermath of severe head trauma.

Question 24

rash in pregnancy?

Answer 24

Question 25

Answer 25

Question 26

50 yo symmetrical erythematous lesions are found with an orange peel texture.

Answer 26

Grave's disease, orange peel shin lesions - pretibial myxoedema

Question 27

A 23-year-old female presents with red, thickened skin on the soles. On closer inspection a crop of raised lesions are seen.

Answer 27

Palmoplantar pustulosis

Question 28

22-year-old man presents with a 3 cm area of hyperkeratotic skin on the heel of his right foot. A number of pinpoint petechiae are seen in the lesion.

Answer 28

Mosaic wart

Question 29

excessively smelly feet. On examination he has white skin over the sole of the forefoot bilaterally. Small holes can be seen on the surface of the affected skin.

Answer 29

Pitted keratolysis

Question 30

Acute onset of tear-drop scaly papules on trunk and limbs

Answer 30

guttate psoriasis

Question 31

Itchy

Answer 31

single well-demarcated, erythematous circular patch with a raised edge and central hypopigmentation. Combined with the history of itch, the most likely diagnosis is tinea corporis (ringworm). causes include Trichophyton rubrum and Trichophyton verrucosum (e.g. From contact with cattle)

Question 32

bullous pemphigoid vs pemphigus vulgaris

Answer 32

pemphigus vulgaris: blisters are flaccid and easily ruptured when touched.

Question 33

15-year-old female presents to ambulatory care with a painful pruritic rash that has rapidly worsened over the last 10 hours. On examination, she has a monomorphic rash with punched out erosions over her cheeks and bilateral dorsal wrists. She is admitted for IV antivirals and observation. ?

Answer 33

Eczema herpeticum is a primary infection of the skin caused by herpes simplex virus (HSV)

Question 34

itchy white spots typically seen on the vulva of elderly women

Answer 34

Lichen sclerosus

Question 35

allergic contact dermatitis dx?

Answer 35

skin patch test

Question 36

mild acne, open and closed comedones (blackheads and whiteheads) tx?

Answer 36

Prescribe a topical retinoid (tretinoin, isotretinoin, or adapalene) or benzoyl peroxide (especially if papules and pustules are present) as first-line treatment. azelaic acid if both topical retinoids and benzoyl peroxide are poorly tolerated.

Question 37

common complications of seborrhoeic dermatitis

Answer 37

Otitis externa and blepharitis

Question 38

78 year-old woman presents with a poorly healing area of skin on her ankle. shallow ulcer anterior to the medial malleolus. dx? tx?

Answer 38

Venous ulceration

Question 39

Keloid scars tx?

Answer 39

early keloids may be treated with intra-lesional steroids e.g. triamcinolone

Question 40

........are a vascular birthmark that do not spontaneoulsy resolve

Answer 40

port of wine stain

Question 41

Scalp psoriasis - first-line treatment?

Answer 41

topical potent corticosteroids

Question 42

Molluscum contagiosum cause? tx?

Answer 42

virus (MCV), a member of the Poxviridae family. Reassure people that molluscum contagiosum is a self-limiting condition. Spontaneous resolution usually occurs within 18 months

Question 43

benign, painful nodule on the ear, more common in men than women?

Answer 43

Chondrodermatitis nodularis

Question 44

bilateral erythematous lesions on her shins surrounded by telangiectasia

Answer 44

Necrobiosis lipoidica

Question 45

Answer 45

Pyogenic granuloma is a relatively common benign skin lesion.

Question 46

factors may exacerbate psoriasis:

Answer 46

trauma alcohol drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab withdrawal of systemic steroids

Question 47

classic descriptions for polycythemia?

Answer 47

Question 48

Nail changes that may be seen in psoriasis

Answer 48

pitting onycholysis (separation of the nail from the nail bed) subungual hyperkeratosis loss of the nail

Question 49

first-line for hyperhidrosis

Answer 49

Topical aluminium chloride

Question 50

serious cutaneous form of T-cell lymphoma that can present like eczema or psoriasis

Answer 50

Mycosis fungoides

Question 51

Acne vulgaris in pregnancy- oral abx choice?

Answer 51

oral erythromycin

Question 52

sebaceous cyst mx?

Answer 52

Surgical excision of sebaceous cyst as a whole structure is required to prevent reoccurrence

Question 53

Scabies is caused by mx?

Answer 53

mite Sarcoptes scabiei

Question 54

Toxic epidermal necrolysis (TEN presentation? what causes it?

Answer 54

potentially life-threatening skin disorder that is most commonly seen secondary to a drug reaction. positive Nikolsky's sign: the epidermis separates with mild lateral pressure

Question 55

Bullous pemphigoid skin biopsy?

Answer 55

immunofluorescence shows IgG and C3 at the dermoepidermal junction

Question 56

Impetigo mx?

Answer 56

topical fusidic acid if hydrogen peroxide not suitable extensive: oral flucloxacillin oral erythromycin if penicillin-allergic

Question 57

Answer 57

actinic keratosis

Question 58

dimples when pressure is applied.

Answer 58

dermatofibromas,

Question 59

Pemphigoid gestationis vs Polymorphic eruption of pregnancy

Answer 59

Pemphigoid gestationis: BLISTERS - 2ND, 3RD TRIMESTER Polymorphic eruption of pregnancy is not associated with blistering- 3RD TRIMESTER

Question 60

Dermatophyte nail infections MX>

Answer 60

oral terbinafine

Question 61

Acne vulgaris: management Should be avoided due to an increased risk of drug-induced lupus and hyperpigmentation?

Answer 61

Oral minocycline

Question 62

Acne vulgaris: management most likely to affect the hepatic metabolism of other medications

Answer 62

Oral erythromycin