Dermatology

Question 1

Describe 4 reasons why skin disease is relevant to dentists

Answer 1

1. Oral or lip conditions which need referral
2. Skin disease may distress patients
3. Skin cancer is very common and early pick up improves outcomes
4. Recognition of disease can improve quality of life

Question 2

Name 3 common oral conditions

Answer 2

1. Stomatitis
2. Burning Mouth Syndrome
3. Dental Sinus

Question 3

Name 5 causes of stomatitis

Answer 3

1. Infection
2. Inflammation
3. Contact
4. Drugs / Smoking
5. Malignancy

Question 4

Name 3 signs of inflammation of oral mucosa

Answer 4

1. Pain
2. Stinging
3. Soreness

Question 5

Name 4 signs of stomatitis

Answer 5

1. Red patches
2. Mouth ulcers
3. Blisters
4. Swelling

Question 6

Name 3 infections which cause stomatitis

Answer 6

1. Candidiasis
2. Enterovirus
3. HIV manifestations

Question 7

Name 3 inflammatory causes of stomatitis

Answer 7

1. Apthous ulceration
2. IBD
3. Lichen Planus

Question 8

Name a drug which may cause stomatitis

Answer 8

Methotrexate

Question 9

Name 2 types of malnutrition which may contribute to stomatitis

Answer 9

1. Iron

2. Vitamin C

Question 10

Name 3 types of irritation which may cause stomatitis

Answer 10

1. Burns
2. Poor hygeine
3. Dentures

Question 11

Describe the clinical symptoms of burning mouth syndrome

Answer 11

• Oral pain
• Abnormal taste
• Dry mouth feeling
• Normal clinical examination

Question 12

Name 4 organic diseases to rule out when diagnosing burning mouth syndrome

Answer 12

1. Malnutrition
2. Xerostomia
3. Poor dental hygeine
4. Systemic conditions

Question 13

What is a dental sinus?

Answer 13

Channel which develops from a chronic dental abscess intra orally or on facial skin

Question 14

What is the usual treatment plan for dental sinus?

Answer 14

Extraction and antibiotics, with healing in 1-2 weeks

Question 15

Name 3 causes of oral pigmentation

Answer 15

1. Racial
2. Medication
3. Irritation and smoking

Question 16

Describe a type of pigmentation which is important for an onward referral

Answer 16

Asymmetric localized pigmentation

Question 17

Name 4 types of common lip conditions

Answer 17

1. Cheilitis
2. Angioedema
3. Infections
4. Lesions

Question 18

Name 4 types of cheilitis

Answer 18

1. Angular
2. Eczematous
3. Granulomatous
4. Actinic

Question 19

What is the usual cause of angular cheilitis?

Answer 19

Vitamin defects

Question 20

What is the usual cause of eczematous cheilitis?

Answer 20

Eczema

Question 21

What is the usual cause of granulomatous cheilitis?

Answer 21

Linked to inflammatory bowel conditions

Question 22

What is the usual cause of actinic cheilitis?

Answer 22

Usually linked to UV exposure and increased risk of squamous melanoma

Question 23

Name 3 infections which may affect the lips

Answer 23

1. HSV (Cold sores)
2. HHV (Warts)
3. Impetigo

Question 24

Name a vascular lesion affecting the lips

Answer 24

Venous lake

Question 25

Name 2 pigmented lesions of the lip

Answer 25

1. Labial melanocytic macule (freckle - investigate if multiple present) 2. Mucosal melanoma

Question 26

Name 4 common facial skin conditions

Answer 26

1. Psoriasis 2. Eczema 3. Acne 4. Rosacea

Question 27

Name 3 positives effects of sun exposure

Answer 27

1. Vitamin D production 2. Increased sense of wellbeing 3. Increase in physical activity

Question 28

Name 4 disadvantages of skin exposure

Answer 28

1. Sunburn 2. Accelerated ageing of skin 3. Skin cancer 4. Aggravation of some skin disease

Question 29

Describe the UV index

Answer 29

1-2 - Low Risk (Unlikely to burn any skin) 3-4 - Low to Medium Risk (fair of sensitive skin at medium risk) 5-6 - High risk (majority individuals should use sun protection) 7-8 - High to very high risk (everyone should use sunscreen) 9-10 - Very high risk (individuals with brown / black skin at medium to high)

Question 30

Name 3 effects of photoageing

Answer 30

1. Wrinkles and fragile skin 2. Altered pigmentation 3. Pre-malignancy and skin cancer

Question 31

Describe how the skin becomes wrinkled due to photoageing

Answer 31

- Water content in skin is reduced - Skin thins and flattens - Reduced collagen and abnormal elastin

Question 32

Name 2 non-melanomas which may be caused by sun exposure

Answer 32

1. Basal cell carcinoma | 2. Squamous cell carcinoma

Question 33

Describe malignant melanoma caused by sun exposure

Answer 33

- Pigmented form of skin cancer - Potentially fatal - Early diagnosis is key to survival - Mucosal melanoma is rare and found on hard palate

Question 34

Describe the pneumonic used for the early detection of melanoma

Answer 34

A - Asymmetry B - Boarders (uneven boarders) C - Colour (dark black or multiple coloured) D - Diameter (over 6mm) E - Evolving (change in size, shape or colour)

Question 35

Name 5 risk factors for melanoma

Answer 35

1. Age 2. Fair skin types 3. Sunburn episode 4. UV exposure 5. Immunosuppression

Question 36

Describe sun protection advice

Answer 36

- Avoid burn and frequent exposure - Slip, Slap, Slop - Shade between 11 and 3 - Vitamin D replacement