Derma

Question 1

When is topical steroid given in molluscum contagiosum?

Answer 1

When lesion is a/w eczema

Question 2

Shingles management including immedate mx

Answer 2

Immediate
For neuropathic pain : tricyclic antidepressants: amutriptylline, gabapentin

Other if presented within 72 hrs of onset of vesicles or in ophthalmic herpes zoster or in immunocompromised oral famciclovir or acyclovir or valacyclovir
In pregnant only famciclovir (1st line) or valacylovir (2nd line)

Question 3

Syndrome in which there is acute peripheral facial neuropathy caused by reactivation of a latent VZV onfection is called?
And its triad

Answer 3

Ramsay hunt syndrome

1.ear pain deep in ear which may radiate to ear pinna thus causing paroxysmal pain A/W constant, diffuse, dull background pain.
2. vesicles in auditory canal and auricle
3.. Facial palsy

Question 4

Clincial manifestations of ramsay hunt syndrome

Answer 4

1. Vesicular rash of ear or mouth
   2.facial palsy or paresis
   3.vertigo and ipsilateral hearing loss(50%)
   4.tinnitus
   5.hyperacusis
   6.otalgia
   7.headache
   8.dysarthria
   9.gait ataxia
   10.fever
   11.cervical lymphadenopathy
2. Cranial nerves 8,9,10,5,6 involvement
3. Rash getting infected - cellulitis

Question 5

Ramsay hunt syndrome treatment

Answer 5

Within 72 hrs of rash famciclovir, acyclovir or valacyclovir. Same if immunocompromised or herpes zoster ophthalmicus

In chdren and pregnant women- acyclovir

2.oral steroid prednisolone tapered to 5 mg over next 2 weeks. Useless if given without antiviral.

Question 6

When is iv antihistamines given in urticaria?

Answer 6

When severe or eyelids are involoved