Derm

Question 1

What is Polymorphic eruption of pregnancy?

Answer 1

Typically begins in the third trimester. It often starts within stretch marks on the abdomen, particularly around the umbilicus, before spreading to other areas. The rash is characterised by small red bumps and hives, and it can be very itchy.

Question 2

Where do you see Wickham Striae?

Answer 2

Lichen planus

Question 3

How do we treat lichen planus?

Answer 3

Potent topical steroids

Question 4

How does lichen planus present?

Answer 4

planus: purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham’s striae over surface. Oral involvement common

Question 5

How do we treat plaque psoriasis?

Answer 5

NICE recommends a potent corticosteroid (for a maximum of 8 weeks) plus a vitamin D analogue, both once daily, for first-line treatment.

Question 6

Define severe acne

Answer 6

In severe acne, there are nodules and cysts (nodulocystic acne), as well as a preponderance of inflammatory papules and pustules. There is a high risk of scarring (or scarring may already be evident), and there is likely to be considerable psychosocial morbidity.

Question 7

How would you manage severe acne?

Answer 7

Consider prescribing an oral antibiotic in combination with a topical drug whilst waiting for an appointment. Benzoyl peroxide or a topical retinoid are recommended as adjunctive treatment for most people. Azelaic acid is an alternative, but avoid the use of topical antibiotics with oral antibiotics

Question 8

What are milia?

Answer 8

Milia are small, benign, keratin-filled cysts that typically appear around the face. They may appear at any age but are more common in newborns.

Question 9

What is pityriasis versicolor?

Answer 9

This condition is a common yeast infection of the skin, caused by the fungus Malassezia. The primary symptom includes hypopigmented or hyperpigmented macules and patches on the chest and back. These patches may be pink, tan, brown or white, and they often become more noticeable with tanning, as in this case. In addition, these lesions can sometimes be slightly scaly.

Question 10

How does dermatitis herpetiformis present?

Answer 10

This patient’s presentation of an intensely itchy, symmetrical vesicular rash on the knees and back of arms is highly suggestive of dermatitis herpetiformis. Dermatitis herpetiformis is an autoimmune skin condition associated with coeliac disease, and it often presents as a pruritic, blistering rash on extensor surfaces such as the elbows, knees, and buttocks.

Question 11

What is hereditary haemorrhagic telangiectasia?

Answer 11

Hereditary haemorrhagic telangiectasia often presents with multiple telangiectasia and bleeding from the rectum or more commonly, the nose. One of the criteria for diagnosis is the presence of the disease in a first degree relative, which the patient alludes to when the telangiectasia on their lips and tongue is noted.

Question 12

What is a capillary haemangioma?

Answer 12

These appear as a small red patch which develops in the first month of life, increasing in size until around 9 months and becoming more vascular. They are not present at birth and regress spontaneously. Parents should be reassured that no treatment is needed and there is no sinister cause.

Question 13

How do we treat impetigo?

Answer 13

Topical hydrogen peroxide, then topical fusidic acid

Question 14

What is leukoplakia?

Answer 14

Leukoplakia is a premalignant condition which presents as white, hard spots on the mucous membranes of the mouth. It is more common in smokers.

Leukoplakia is said to be a diagnosis of exclusion. Candidiasis and lichen planus should be considered, especially if the lesions can be ‘rubbed off’

Biopsies are usually performed to exclude alternative diagnoses such as squamous cell carcinoma and regular follow-up is required to exclude malignant transformation to squamous cell carcinoma, which occurs in around 1% of patients.

Question 15

How does guttate psoriasis present?

Answer 15

Guttate psoriasis is a subtype of psoriasis that typically affects children and young adults following infection with Streptococcus sp. (as seen here with this patient’s recent tonsillitis infection). The rash presents acutely with multiple small scaly and erythematous patches of skin appearing over the trunk and limbs. They often have a tear-drop shape.

Question 16

What is acanthosis nigricans?

Answer 16

Acanthosis nigricans is a skin condition characterised by dark, thickened patches of skin that can appear in various parts of the body including the axilla. The image shows a velvety, hyperpigmented rash which is typical of acanthosis nigricans. It’s often associated with insulin resistance and can be an early sign of type 2 diabetes.

Question 17

What is molluscum contagiousum?

Answer 17

Molluscum contagiosum is a common viral skin infection caused by the molluscum contagiosum virus (MCV). It presents as multiple small, raised, flesh-coloured or pearly white papules with a central dimple (umbilication). It usually affects children and spreads through direct skin-to-skin contact or via fomites.

Question 18

How does erythema nodosum present?

Answer 18

It presents as tender, erythematous nodules typically located on the anterior shins but can also appear on the forearms.

Question 19

How do we treat rosacea?

Answer 19

First-line management of this condition is with topical ivermectin

Question 20

What is the Parkland formula used for?

Answer 20

Parkland formula is used to calculate the volume of IV fluid required for resuscitation over the first 24 hours after the burn

Question 21

Name two non-sedating antihistamines

Answer 21

Loratadine and cetirizine

Question 22

How do we treat venous ulceration

Answer 22

Compression bandaging

Question 23

What is toxic epidermal necrolysis?

Answer 23

Toxic epidermal necrolysis (TEN). The patient’s presentation of widespread rash with fluid-filled blisters, fever, and recent initiation of phenytoin strongly suggests TEN. This condition is a severe cutaneous adverse reaction often triggered by medications such as antiepileptic drugs like phenytoin. In TEN, there is extensive detachment of the epidermis, leading to the formation of large fluid-filled blisters that easily separate upon pressure. The patient’s blood results also show signs of acute kidney injury (AKI) which can be a complication associated with TEN.

Question 24

How does pityriasis versicolor present?

Answer 24

a skin condition caused by an overgrowth of Malassezia yeast. It is most common in young people, especially males. It causes multiple patches of skin discolouration, mainly to the trunk. The patches may appear pale brown, pink, or may appear depigmented especially in patients with dark skin. They may also be mildly flaky and itchy. The condition can often present after spending time in sunny, humid environments. It is treated with topical antifungals eg. ketoconazole shampoo.

Question 25

What is erythema multiforme?

Answer 25

Erythema multiforme is an acute, immune-mediated skin condition that typically presents with target-like lesions on the skin and mucous membranes. In this patient, the history of a sore throat followed by fever, myalgia, and lethargy along with the appearance of a widespread erythematous rash with target lesions and mucosal involvement (conjunctivitis and oral ulceration) strongly suggest erythema multiforme major.

Question 26

What are actinic keratoses?

Answer 26

Actinic, or solar, keratoses (AK) is a common premalignant skin lesion that develops as a consequence of chronic sun exposure Features small, crusty or scaly, lesions may be pink, red, brown or the same colour as the skin typically on sun-exposed areas e.g. temples of head multiple lesions may be present

Question 27

What is molluscum contagiosum, and how do we manage it?

Answer 27

This skin condition is caused by a pox virus and can be identified by its raised, pearly white, and umbilicated lesions. Supportive care is the mainstay of treatment for this condition, although specialist treatment may be required if the patient is immunocompromised. This condition normally clears up on its own within 18 months. Time off school is not necessary but, as the condition is infectious, it is advised to avoid sharing baths, towels, or clothing with others to prevent transmission.

Question 28

Which medications cause erythema multiforme?

Answer 28

Drugs causing erythema multiforme - PANCaCes Penicillin Allopurinol NSAIDs Carbamazepine COCP

Question 29

How do we manage rosacea?

Answer 29

Rosacea: topical ivermectin is first-line for patients mild papules and/or pustules Second line Oral oxytetracycline

Question 30

How does rosacea present?

Answer 30

They describe flushing with a relationship to alcohol, as well as some 'spots' which can often be mistaken for acne vulgaris. In mild cases, the recommended treatment is topical ivermectin.

Question 31

What are keloid scars?

Answer 31

Keloid scars are characterised by an overgrowth of granulation tissue at the site of a healed skin injury, which is then replaced by excessive amounts of collagen, resulting in a raised scar that extends beyond the site of original injury.How

Question 32

How do we manage keloid scars?

Answer 32

Intra-lesional steroid injections, such as triamcinolone acetonide, are commonly used to treat keloids due to their anti-inflammatory properties and their ability to inhibit fibroblast proliferation and collagen synthesis.

Question 33

How do we treat severe rosacea?

Answer 33

Rosacea: a combination of topical ivermectin + oral doxycycline is first-line for patients with severe papules and/or pustules

Question 34

What is the most common SE of isotretinoin?

Answer 34

Dry skin

Question 35

What is eczema herpeticum?

Answer 35

Eczema herpeticum is a potentially serious complication caused by the herpes simplex virus (Herpes simplex) infecting areas of broken skin affected by atopic eczema. This condition requires urgent assessment and treatment with antiviral medication (e.g., acyclovir) in a hospital setting to prevent complications such as secondary bacterial infections or dissemination of the virus.

Question 36

What is the most common malignancy associated with acanthosis nigricans?

Answer 36

The most common malignancy associated with acanthosis nigricans is gastrointestinal adenocarcinoma

Question 37

What is acanthosis nigricans?

Answer 37

hyperpigmentation and thickening of the skin in her groin and axilla are noted

Question 38

What is the first-line treatment for venous ulcers?

Answer 38

Compression bandaging

Question 39

What is the difference between bullous pemphigold and pemphigus vulgaris?

Answer 39

Blisters/bullae no mucosal involvement (in exams at least*): bullous pemphigoid mucosal involvement: pemphigus vulgaris

Question 40

When is a BCC referred for urgent removal?

Answer 40

From my experience in primary care a BCC could be referred as 2WW if in the 'T' zone (i.e. around eyes & nose), otherwise the referral would be rejected or downgraded to non-urgent referral

Question 41

How do we treat impetigo?

Answer 41

NICE now recommend hydrogen peroxide 1% cream for 'people who are not systemically unwell or at a high risk of complications' the change was announced in 2020 by NICE and Public Health England and seems aimed at cutting antibiotic resistance the evidence base shows it is just as effective at treating non-bullous impetigo as a topical antibiotic topical antibiotic creams: topical fusidic acid topical mupirocin should be used if fusidic acid resistance is suspected MRSA is not susceptible to either fusidic acid or retapamulin. Topical mupirocin should, therefore, be used in this situation

Question 42

What are keloid scars, and where are they most common?

Answer 42

Keloid scars are a result of an overgrowth of dense fibrous tissue that usually develops after the healing of a skin injury. The scar extends beyond the borders of the original wound, does not regress and tends to recur after excision. The sternum, along with other areas such as shoulders, upper arms and earlobes, is particularly prone to keloid formation due to high tension in these areas.

Question 43

What is a Curling's ulcer?

Answer 43

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

Question 44

How does guttate psoriasis present?

Answer 44

Guttate psoriasis is a type of psoriasis characterized by the sudden onset of small, erythematous, scaly lesions that are typically less than 1 cm in diameter. It is commonly triggered by a preceding streptococcal infection, such as exudative tonsillitis as noted in the patient's history. The widespread distribution of the rash over the torso and limbs also supports this diagnosis.

Question 45

What is the Fitzpatrick Classification?

Answer 45

I: Never tans, always burns (often red hair, freckles, and blue eyes) II: Usually tans, always burns III: Always tans, sometimes burns (usually dark hair and brown eyes) IV: Always tans, rarely burns (olive skin) V: Sunburn and tanning after extreme UV exposure (brown skin, e.g. Indian) VI: Black skin (e.g. Afro-Caribbean), never tans, never burns

Question 46

How do we treat scalp psoriasis?

Answer 46

first-line treatment is topical potent corticosteroids

Question 47

How do we treat chronic plaque psoriasis?

Answer 47

Vit d analogue

Question 48

How does lichen planus present?

Answer 48

purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham's striae over surface. Oral involvement common

Question 49

How does lichen sclerosus present?

Answer 49

sclerosus: itchy white spots typically seen on the vulva of elderly women

Question 50

What is vitiligo?

Answer 50

Vitiligo is an autoimmune condition which results in the loss of melanocytes and consequent depigmentation of the skin.

Question 51

What are seborrhoeic keratoses?

Answer 51

Seborrhoeic keratoses are benign skin lesions that commonly occur in older individuals. They present as well-defined, waxy, 'stuck-on' papules or plaques with a variable colour ranging from light tan to dark brown. The surface of these lesions can be smooth or rough and may show keratotic plugs. They can appear anywhere on the body except the palms and soles.

Question 52

How do we treat lichen planus?

Answer 52

Potent topical steroids are the first-line treatment for lichen planus

Question 53

What is hereditary haemorrhagic telangiectasia?

Answer 53

This condition, also known as Osler-Weber-Rendu syndrome, is a genetic disorder that leads to abnormal blood vessel formation in the skin, mucous membranes and often in organs such as the lungs, liver and brain. Recurrent epistaxis (nosebleeds) are a common symptom because of the fragile blood vessels in the nasal lining.

Question 54

What is dermatitis herpetiformis?

Answer 54

This patient has an itchy rash that most closely resembles dermatitis herpetiformis. Dermatitis herpetiformis is most commonly caused by coeliac disease; therefore, is treated with a gluten-free diet.

Question 55

Give four causes of erythema multiforme

Answer 55

Causes viruses: herpes simplex virus (the most common cause), Orf* idiopathic bacteria: Mycoplasma, Streptococcus drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine connective tissue disease e.g. Systemic lupus erythematosus sarcoidosis malignancy

Question 56

What is necrobiosis lipoidica diabeticorum.

Answer 56

This condition is a rare skin disorder of unclear etiology and is more common in patients with diabetes, though it can also occur in non-diabetics. The characteristic clinical presentation includes shiny plaques on the anterior aspect of the lower legs that are yellowish-brown with telangiectasias and atrophic skin. The plaques may be asymptomatic or painful and usually start as small papules that slowly enlarge.

Question 57

How do we manage guttate psoriasis?

Answer 57

Management most cases resolve spontaneously within 2-3 months there is no firm evidence to support the use of antibiotics to eradicate streptococcal infection

Question 58

How do we manage pityriasis rosea?

Answer 58

Conservative management (self-limiting) is correct. The management of pityriasis rosea is generally conservative as the rash self-resolves within a couple of months or so.

Question 59

What is Peutz-Jegher's syndrome?

Answer 59

Peutz-Jeghers syndrome is an autosomal dominant genetic disorder characterised by the development of non-cancerous growths called hamartomatous polyps in the gastrointestinal tract and a characteristic pigmentation around the mouth, lips, eyes and genitalia.

Question 60

How do we manage rosacea?

Answer 60

Rosacea: topical ivermectin is first-line for patients mild papules and/or pustules

Question 61

What is the Koebner phenomenon?

Answer 61

In vitiligo, skin trauma may precipitate new lesions

Question 62

How do dermatofibromas present?

Answer 62

This image shows a light pink / brown, well-defined, symmetrical nodule. Although not evident in the picture, the 'dimple' sign is described in the brief. This is when a lesion dimples when it is pinched. This sign is typically associated with dermatofibromas, which are common, benign, fibrous nodules. Like in this case, these lesions are typically found on the lower limbs and may form in relation to trauma such as insect bites. These lesions are often asymptomatic but may be associated with mild pain or itch.

Question 63

Where do we use oral retinoin?

Answer 63

Retinoin, also known as isotretinoin, is a derivative of vitamin A and is highly effective for severe acne that has not responded to other treatments. It works by reducing the production of sebum, which can lead to acne if produced in excess. This patient has evidence of scarring, indicating severe acne that warrants this treatment. According to UK guidelines from the National Institute for Health and Care Excellence (NICE), oral retinoin should be considered for individuals with severe acne or acne that is resistant to treatment.

Question 64

How does dermatitis herpetiformis present on skin biopsy?

Answer 64

Dermatitis herpetiformis rash is diagnosed by skin biopsy which shows a granular pattern of IgA deposition. This is characterised by intense itchy bumps and blisters in a rash-like form.

Question 65

Which drugs may worsen psoriasis?

Answer 65

BLANQ (French for white, plaques are white-ish) B - beta blockers L - lithium A - ACEI/ARBs + alcohol N - NSAIDs Q - quinines I - infliximab

Question 66

A 42-year-old man with chronic plaque psoriasis is reviewed by his GP. He has been applying regular emollients, which help with itching, but his plaques have not visibly improved. After eight weeks of using a potent corticosteroid and a vitamin D analogue once daily, there is no improvement, and he reports frustration as symptoms interfere with work. What is the most appropriate next step in management?

Answer 66

Prescribe a vitamin D analogue to be applied twice daily is correct because the patient has not responded to eight weeks of potent corticosteroid and vitamin D analogue therapy in this scenario. NICE guidelines recommend increasing the frequency of the vitamin D analogue to twice daily or continuing the current regimen for another four weeks if there is improvement. Since this patient has seen no progress, the next step is to increase the frequency of the vitamin D analogue while stopping the corticosteroid.

Question 67

What is pyoderma gangrenosum?

Answer 67

Pyoderma gangrenosum is a rare, non-infectious, inflammatory disorder. It is an uncommon cause of very painful skin ulceration. It may affect any part of the skin, but the lower legs are the most common site. Pathophysiology pyoderma gangrenosum is classified as a neutrophilic dermatosis neutrophilic dermatoses are skin conditions characterised by dense infiltration of neutrophils in the affected tissue, and this is often seen on biopsy

Question 68

A diagnosis of alopecia areata is suspected. Which one of the following is an appropriate management plan?

Answer 68

Topical corticosteroid + referral to dermatologist

Question 69

What is tinea corporis?

Answer 69

The image shows a 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). Pustules and papules may also be seen. Tinea corporis is a fungal skin infection secondary to Trichophyton rubrum and is capable of affecting most parts of the body. Treatment is with antifungal drugs such as oral fluconazole.

Question 70

How do we manage bullous pemphigold?

Answer 70

Refer to secondary care. Bullous pemphigoid is an autoimmune blistering disease that primarily affects the elderly. It is characterised by tense blisters on normal or erythematous skin, often with a urticarial pre-stage and it can be life-threatening if left untreated. The diagnosis of bullous pemphigoid requires histopathological examination and direct immunofluorescence testing, which are not available in primary care. Therefore, patients suspected of having bullous pemphigoid should be referred to secondary care (dermatology) promptly for further evaluation and management.

Question 71

How does alopecia areata and alopecia totalis present?

Answer 71

causes well-circumscribed areas of total hair loss Alopecia totalis, which causes complete loss of all hair of the head and face.

Question 72

How does Telogen effluvium present?

Answer 72

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

Question 73

What is chondrodermatitis nodularis helicis?

Answer 73

Chondrodermatitis nodularis helicis is a benign, painful nodule on the ear, more common in men than women

Question 74

Face, flexural and genital psoriasis management

Answer 74

NICE recommend offering a mild or moderate potency corticosteroid applied once or twice daily for a maximum of 2 weeks

Question 75

What is tylosis?

Answer 75

Tylosis = focal thickening of the skin of the hands and feet incase anyone else didn't know

Question 76

Which cancer is associated with tylosis?

Answer 76

Oesophageal cancer

Question 77

What is ichthyosis?

Answer 77

Ichthyosis is a condition that causes widespread and persistent thick, dry, 'fish-scale' skin.

Question 78

Which ca is associated with ichthyosis?

Answer 78

Lymphoma

Question 79

What does herpes zoster cause?

Answer 79

Herpes zoster causes chickenpox

Question 80

How do we treat chronic plaque psoriasis?

Answer 80

Topical potent corticosteroid + vitamin D analogue is first-line for chronic plaque psoriasis

Question 81

Which one of the following complications is most associated with psoralen + ultraviolet A light (PUVA) therapy?

Answer 81

SCC

Question 82

How do we treat pityriasis versicolor?

Answer 82

Ketoconazole shampoo

Question 83

How do we treat actinic keratoses?

Answer 83

Actinic keratoses are premalignant and may be found incidentally on those with high cumulative sun exposure in primary care - topical fluorouracil

Question 84

Give two complications of seborrhoeic dermatitis

Answer 84

Otitis externa and blepharitis are common complications of seborrhoeic dermatitis

Question 85

How do we treat lichen planus?

Answer 85

Topical corticosteroids like clobetasone butyrate are the first-line treatment for cutaneous lichen planus according to UK guidelines. They reduce inflammation and alleviate itching by inhibiting cytokine production and suppressing eosinophil action.

Question 86

What is associated with keratoderma blennorhagicum

Answer 86

Keratoderma blennorhagicum presents as vesico-pustular waxy yellow-brown lesions on the palms and soles. It is associated with reactive arthritis.

Question 87

What is pompholyx eczema?

Answer 87

Pompholyx eczema (also known as dyshidrotic eczema) is a type of vesicular hand dermatitis. It is more common in young adult females and is commonly related to sweating, with flares during hot weather and humid conditions. It manifests as recurrent crops of vesicles and/or blisters on the palms which can cause intense itching and burning. The vesicular stage is usually followed by a dry, desquamating phase in which the skin can peel, crack or crust.

Question 88

How does shingles present?

Answer 88

Shingles is a clinical diagnosis and is characterised by dermatomal pain and a papular rash. Typically, the pain precedes the development of the rash and may persist for longer (known as postherpetic pain)

Question 89

How do we manage shingles?

Answer 89

NICE guidelines state that oral antivirals should be commenced within 72 hours of onset of symptoms. The first-line oral antiviral is famciclovir or valacyclovir and these should be given for 7 days. The second-line option is oral aciclovir, as studies have shown that treatment with famciclovir and valacyclovir reduced the likelihood of postherpetic pain when compared to treatment with aciclovir.

Question 90

What is Sweet's syndrome?

Answer 90

Sweet's syndrome, also known as acute febrile neutrophilic dermatosis, is characterised by tender, erythematous plaques and nodules, often accompanied by fever and neutrophilia. It is commonly associated with malignancy (particularly haematological), inflammatory bowel disease, or medications

Question 91

How do we treat capillary haemangiomas?

Answer 91

Propranolol is now considered the treatment of choice for capillary haemangioma. 'Propranolol, a nonselective β-blocker, exerts an indirect effect on the vasculature by leaving α-adrenergic receptors unopposed, resulting in peripheral vasoconstriction.'

Question 92

How does the mx of chronic plaque psoriasis and scalp psoriasis differ?

Answer 92

No vit D analogue with scalp, potent topical steroids with both

Question 93

What can cause spider naevi?

Answer 93

Spider naevi (also called spider angiomas) describe a central red papule with surrounding capillaries. The lesions blanch upon pressure. Spider naevi are almost always found on the upper part of the body. Spider naevi can be differentiated from telangiectasia by pressing on them and watching them fill. Spider naevi fill from the centre, telangiectasia from the edge . Around 10-15% of people will have one or more spider naevi and they are more common in childhood. Other associations liver disease pregnancy combined oral contraceptive pill

Question 94

What is the most common cancer after a renal transplant?

Answer 94

squamous cell carcinoma of the skin. All patients who undergo a renal transplant are at an increased risk of a number of malignancies, due to T-cell ablating immunosuppression, which inhibits the immune system's normal ability to recognise and kill neoplastic cells. Of these, the most common cancer after a renal transplant is squamous cell skin cancer, which is approximately 250 times more common in renal transplant patients than in the general population.

Question 95

What is Necrobiosis lipoidica?

Answer 95

This condition is a rare skin disorder that typically presents in middle-aged women with diabetes, although it can also occur in non-diabetic individuals. It is characterised by bilateral, well-demarcated erythematous plaques on the shins which are often surrounded by telangiectasia and may have a yellowish hue due to lipid deposition. The lesions are usually asymptomatic but may be associated with tenderness or itchiness.

Question 96

What is Pemphigoid gestationis?

Answer 96

also known as herpes gestationis (despite having no relation to herpes virus infection). This is an autoimmune blistering disorder specific to pregnancy, typically presenting in the second or third trimester. The condition is characterised by intensely pruritic urticarial plaques that progress to tense vesicles and bullae. The pathognomonic feature is the initial appearance of lesions in the periumbilical region, which then spread to other areas of the body.

Question 97

How does pemphigold gestationis and polymorphic eruption of pregnancy dioffer?

Answer 97

Polymorphic eruption of pregnancy is not associated with blistering

Question 98

What is adapalene? Where is it contraindicated?

Answer 98

Topical adapalene is a type of retinoid and is therefore strongly contraindicated in pregnancy.

Question 99

How does pemphigoid differ to phemphigold vulgaris?

Answer 99

Pemphigoid is another autoimmune blistering disorder, but it differs from pemphigus vulgaris in that it involves the formation of tense blisters rather than flaccid ones. In pemphigoid, autoantibodies target components of the basement membrane zone, leading to subepidermal blister formation. Due to the deeper location of these blisters compared to those seen in pemphigus vulgaris, they are more resistant to rupture.

Question 100

A 64-year-old woman presents with severe mucosal ulceration associated with the development of blistering lesions over her torso and arms. On examination the blisters are flaccid and easily ruptured when touched. What is the most likely diagnosis?

Answer 100

Pemphigus vulgaris

Question 101

What are Keratoacanthomas?

Answer 101

Keratoacanthomas (KAs) are rapidly growing skin tumours that can be difficult to distinguish clinically from squamous cell carcinomas (SCCs)

Question 102

How do we treat Acne vulgaris in pregnancy?

Answer 102

use oral erythromycin if treatment needed

Question 103

The patient's presentation of red crusted lesions around the mouth, known as angular cheilitis, in combination with her history of anorexia nervosa suggests a deficiency in...

Answer 103

zinc

Question 104

What drugs cause erythema nodosum

Answer 104

Drugs causing erythema nodosum- Painful Coloured Shins Penicillin COCP Sulphonamides

Question 105

What do we use serum ACE for?

Answer 105

? sarcoidosis

Question 106

Difference between spider naevi and telangectasias?

Answer 106

Telangiectasias fill from the 'tail' Spider naevi fill from the 'centre of the web'.