Dermatology

Question 1

causes of erythema nodosum

Answer 1

infection; steptococci, TB, brucellosis
sarcoidosis, IBD, behcets
malignancy/ lymphoma
penicillins, sulphonamides, COCP
pregnancy

Question 2

features of rosacea

Answer 2

telangiectasia, erythema with papules and pustules
rhinophyma
blepharitis
symptoms exacerbated by sunlight

Question 3

management of rosacea

Answer 3

sunscreen and camoflage
brimonidine gel PRN for predominant erythema/ flushing
mild-moderate: ivermectin topical, alt metronidazole/azelaic acid
moderate-severe: topical ivermectin + oral doxycycline

Question 4

features of erythema ab igne

Answer 4

erythematous rash
patches of hyperpigmentation and telangiectasia
over exposure to IR radiation

Question 4

causes of pyoderma gangrenosum

Answer 4

idiopathic in 50%
IBC
RA, SLE
myeloproliferative disorders, lymphoma, myeloid leukaemias, monoclonal gammopathy (IgA)
granulomatosis with polyangiitis
primary biliary cirrhosis

Question 4

features of zinc deficiency

Answer 4

acrodermatitis
alopecia
short stature
hypogonadism
hepatosplenomegaly
geophagia
cognitive impairment

Question 4

treatment of dermatophyte nail infections

Answer 4

topical treatment with amorolfine 5% nail lacquer
oral terbinafine for 6 weeks-3 months
oral itraconazole pulsed weekly therapy

Question 4

causes of SJS

Answer 4

penicillin
sulphonamides
lamotrigine, carbamazepine, phenytoin
allopurinol
NSAIDs
oral contraceptive pill

Question 5

features of pityriasis versicolor

Answer 5

affects trunk
Malassezia furfur
hypopigmented patches
mild pruritis

Question 6

management of pityriasis versicolor

Answer 6

topical antifungal
ketoconazole shampoo
oral itraconazole if topical doesnt work

Question 7

features of bullous pemphigoid

Answer 7

itchy tense blisters around flexures
blisters heal without scarring
no mucosal involvement
immunofluorescence shows IgG and C3 at the dermiepidermal junction

Question 8

exacerbating factors of psoriasis

Answer 8

trauma
alcohol
BB
lithium
antimalarials
NSAIDs
ACEi
infliximab
withdrawal of systemic steroids
streptococcal infections trigger guttate psoriasis

Question 9

associated malignancy with tylosis

Answer 9

oesophageal cancer

Question 10

associated malignancy with sweets syndrome

Answer 10

Haematological malignancy e.g. Myelodysplasia - tender, purple plaques

Question 11

pyoderma gangrenosum associated malignancy

Answer 11

Myeloproliferative disorders

Question 12

necroltyic migratory erythema associated malignancy

Answer 12

glucagonoma

Question 13

migratory thrombophlebitis associated malignancy

Answer 13

pancreatic cancer

Question 14

erythroderma associated malignancy

Answer 14

lymphoma

Question 15

erythema gyratum repens associated malignancy

Answer 15

lung cancer

Question 16

dermatomyositis associated malignancy

Answer 16

ovarian and lung cancer

Question 17

Acquired hypertrichosis lanuginosa associated malignancy

Answer 17

Gastrointestinal and lung cancer

Question 18

Acquired ichthyosis associated malignancy

Answer 18

lymphoma

Question 19

Acanthosis nigricans associated malignancy

Answer 19

gastric cancer

Question 20

lichen planus treatment

Answer 20

potent topical steroids
benzydamine mouthwash
oral steroids or immunosuppressants for extensive lichen planus

Question 21

management of venous ulcers

Answer 21

compression bandaging 4 layer
oral pentoxifylline; peripheral vasodilator

Question 22

normal ABPI

Answer 22

0.9-1.2

Question 23

erythema gyratum repens features

Answer 23

concentric erythematous bands with fine white scale in waves located at edge of erythema

Question 24

first line treatment for psoriasis

Answer 24

topical corticosteroid plus topical vitD OD 4 weeks

Question 25

second line treatment for psoriasis

Answer 25

if no improvement after 8 weeks
topical vitD BD

Question 26

third line treatment for psoriasis

Answer 26

if no improvement after 8-12 weeks
topical steroid BD 4 weeks
coal tar preparation OD/BD 4 weeks
short-acting dithranol

Question 27

secondary care management of psoriasis

Answer 27

phototherapy 3 times/week
oral methotrexate
ciclosporin
systemic retinoids
biological agents; infliximab, etanercept, adalimumab
ustekinumab