Dermatology

Question 1

Tinea - define

Answer 1

Dermatophyte fungal infections

Question 2

Tinea capitis - where

Answer 2

Scalp

Question 3

Tinea corporis - where

Answer 3

Trunk, legs or arms

Question 4

Tinea pedis - where

Answer 4

Feet

Question 5

Hereditary haemorrhagic telangiectasia

Answer 5

Autosomal dominant condition

Multiple telangiectasia over the skin and mucous membranes

Question 6

4 main diagnostic criteria of Hereditary haemorrhagic telangiectasia

Answer 6

Epistaxis

Telangiectases: multiple at characteristic sites (lips, oral cavity, fingers, nose)

Visceral lesions: for example gastrointestinal telangiectasia (with or without bleeding), pulmonary arteriovenous malformations (AVM), hepatic AVM, cerebral AVM, spinal AVM

Family history: a first-degree relative with HHT

Question 7

Rosacea features:

Answer 7

Affects nose, cheeks and forehead

Flushing, erythema, telangiectasia → papules and pustules

Question 8

Management of Rosacea (mild)

Answer 8

topical brimonidine gel

mild-to-moderate papules and/or pustules
topical ivermectin is first-line

Question 9

Moderate-to-severe papules and/or pustules in Rosacea

Answer 9

Combination of topical ivermectin + oral doxycycline

Question 10

Pyoderma gangrenosum - define

Answer 10

Non-infectious, inflammatory disorder.

It is an uncommon cause of very painful skin ulceration.

Question 11

Pityriasis rosea

Answer 11

Herald patch (usually on trunk)

Followed by erythematous, oval, scaly patches

Self-limiting

Question 12

Neutrophilic dermatosis

Answer 12

Pyoderma gangrenosum

Neutrophilic dermatoses are skin conditions characterised by dense infiltration of neutrophils in the affected tissue and this is often seen on biopsy.

Question 13

Discoid eczema

Answer 13

Nummular eczema, meaning coin-shaped.

Round or oval plaques on the extremities

Extremely itchy

Question 14

Seborrhoeic keratoses

Answer 14

Benign epidermal skin lesions seen in older people.

Large variation in colour from flesh to light-brown to black

Have a ‘stuck-on’ appearance

Keratotic plugs may be seen on the surface

Question 15

ANCA-associated vasculitides

Answer 15

Granulomatosis with polyangiitis (Wegener’s granulomatosis)

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

Microscopic polyangiitis

Question 16

Immune complex small-vessel vasculitis

Answer 16

Henoch-Schonlein purpura

Goodpasture’s syndrome

Cryoglobulinaemic vasculitis

Question 17

Wegener’s granulomatosis

Answer 17

Granulomatosis with polyangiitis

Question 18

Churg-Strauss syndrome

Answer 18

Eosinophilic granulomatosis with polyangiitis

Question 19

Pemphigoid gestationis

Answer 19

Pruritic blistering lesions

Oral corticosteroids are usually required

Question 20

Topical therapies:

Mild eczema

Answer 20

Hydrocortisone 1%

Question 21

Topical therapies:

Moderate eczema

Answer 21

Betamethasone valerate 0.025% or clobetasone butyrate 0.05%

Question 22

Topical therapies:

Severe eczema

Answer 22

Betamethasone valerate 0.1%

Question 23

First-line for chronic plaque psoriasis

Answer 23

Topical potent corticosteroid + vitamin D analogue

Question 24

The following factors may exacerbate psoriasis:

Answer 24

Trauma

Alcohol

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

Withdrawal of systemic steroids

Question 25

Actinic keratoses

Answer 25

Common premalignant skin lesion that develops as a consequence of chronic sun exposure Small, crusty or scaly, lesions May be pink, red, brown or the same colour as the skin

Question 26

Management options for Actinic Keratoses include

Answer 26

Fluorouracil cream Topical diclofenac Topical imiquimod Cryotherapy Curettage and cautery

Question 27

Erythema multiforme

Answer 27

Hypersensitivity reaction Target lesions

Question 28

Pompholyx - features

Answer 28

Small blisters on the palms and soles pruritic Intensely itchy Burning sensation

Question 29

Dermatitis herpetiformis

Answer 29

Deposition of IgA in the dermis Itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)

Question 30

'Normal' ABPI

Answer 30

0.9 - 1.2 Values below 0.9 indicate arterial disease

Question 31

Management of Venous Ulcers

Answer 31

Compression bandaging Usually four layer

Question 32

Dermatitis herpetiformis - treatment

Answer 32

Gluten-free diet + Topical dapsone

Question 33

Pityriasis versicolor

Answer 33

Superficial cutaneous fungal infection caused by Malassezia furfur

Question 34

Management of Pityriasis versicolor

Answer 34

Topical antifungal Ketoconazole shampoo

Question 35

Common causes of Erythema multiforme

Answer 35

Viruses: herpes simplex virus (the most common cause) Bacteria: Mycoplasma, Streptococcus Drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine Connective tissue disease e.g. Systemic lupus erythematosus Sarcoidosis Malignancy

Question 36

Bullous pemphigoid - define

Answer 36

Autoimmune condition causing sub-epidermal blistering of the skin There is stereotypically NO mucosal involvement

Question 37

Bullous Pemphigoid - antibodies

Answer 37

Against the Hemidesmosomal proteins BP180 and BP230.

Question 38

Erythema nodosum

Answer 38

Inflammation of subcutaneous fat Usually resolves within 6 weeks

Question 39

Management of Lichen Planus

Answer 39

Potent topical steroids

Question 40

Pellagra

Answer 40

Niacin (B3) deficiency Dermatitis, diarrhoea and dementia

Question 41

Shingles - Define

Answer 41

Acute, unilateral, painful blistering rash caused by reactivation of the varicella-zoster virus

Question 42

Large vessel vasculitis examples

Answer 42

Temporal arteritis Takayasu's arteritis

Question 43

Medium vessel vasculitis examples

Answer 43

Polyarteritis nodosa Kawasaki disease

Question 44

Actinic keratoses are premalignant lesions which may develop into ?

Answer 44

Squamous cell carcinomas

Question 45

Complications of psoriasis

Answer 45

Psoriatic Arthritis Metabolic Syndrome

Question 46

Scalp psoriasis - first-line treatment

Answer 46

Topical potent corticosteroids

Question 47

Shingles - define

Answer 47

Herpes zoster infection Is an acute, unilateral, painful blistering rash caused by reactivation of the varicella-zoster virus (VZV)

Question 48

Factors that can exacerbate psoriasis:

Answer 48

Trauma Alcohol Drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab Withdrawal of systemic steroids

Question 49

SJS can occur within ? of first drug exposure

Answer 49

1-4 weeks

Question 50

IgG and C3 deposition at the dermo-epidermal junction

Answer 50

Bullous pemphigoid

Question 51

Acantholysis

Answer 51

Loss of cohesion between adjacent keratinocytes due to a loss of intercellular connections Pemphigus vulgaris

Question 52

Systemic therapy in severe Psoriasis

Answer 52

Methotrexate is first line Ciclosporin

Question 53

Management options for Bowen's disease

Answer 53

Topical 5-fluorouracil Cryotherapy Excision

Question 54

Seborrhoeic dermatitis - treatment

Answer 54

First-line treatment is topical ketoconazole

Question 55

The most common malignancy associated with acanthosis nigricans

Answer 55

Gastrointestinal adenocarcinoma

Question 56

Scabies treatment

Answer 56

Permethrin treatment All skin including scalp + leave for 12 hours + retreat in 7 days

Question 57

Erythema marginatum

Answer 57

Manifestation of acute rheumatic fever Annular erythematous macules or papules that spread outwards with central clearance

Question 58

First line treatment for Toxic epidermal necrolysis

Answer 58

IVIG

Question 59

Face, flexural and genital psoriasis management

Answer 59

Mild or moderate potency corticosteroid applied once or twice daily

Question 60

Scalp psoriasis management

Answer 60

Potent topical corticosteroids used once daily for 4 weeks

Question 61

Chronic plaque psoriasis management

Answer 61

Potent corticosteroid applied once daily plus vitamin D analogue applied once daily