Dermatology

Question 1

Management of shingles
1. Conservstive (2 advice)

Answer 1

1. avoid preg women
2. Could be infectious until vesicles have cristed over usually 5-7 days
3. first line- paracetamol and NSAID
4. Not repsonding - amutriptyline
5. oral corticosteroids may be considered in the first 2 weeks in immunocompetent adults with localized shingles if the pain is severe and not responding to the above treatments
   6.recommend antivirals within 72 hours for the majority of patients,
   - one of the benefits of prescribing antivirals is a reduced incidence of post-herpetic neuralgia, particularly in older people

Question 2

Psoriasis: exacerbating factors

what drugs? 4/6

other (3)

What can trigger guttate psoriasis? (1)

Answer 2

drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab

trauma
alcohol
withdrawal of systemic steroids

Streptococcal infection may trigger guttate psoriasis.