Dermatology

Question 1

symptoms of psoriasis

Answer 1

erythematous, circumscribed

scaly papules & plaques

Question 2

Treatment of plaque psoriasis

Answer 2

topical corticosteroid
phototherapy
methotrexate
biological agent
oral retinoid (not in pregnancy)

second line; ciclosporin

Question 3

Treatment of erythrodermic psoriasis

Answer 3

ciclosporin or biological therapy i.e. infliximab

Question 4

Treatment for guttate psoriasis

Answer 4

phototherapy
methotrexate
oral retinoid
ciclosporin

Question 5

Treatment for pustular psoriasis

Answer 5

oral retinoid

re-PUVA

Question 6

symptoms of eczema

Answer 6

more commonly flexures

infants; cheeks, scalp, forehead

pruritus
dry skin
erythema
scaling
vesicles
lichenification (chronic)
papules
hypopigmentation
excoriations
keratosis pilaris

Question 7

treatment of eczema

Answer 7

acute flare; emollients, intermittent topical corticosteroids

ongoing; emollients, continuous low to mid potency corticosteroids

Question 8

Describe pathogenesis of acne

Answer 8

Abnormal keratinisation
increased sebum production
infection with P acne

Question 9

Symptoms of acne

Answer 9

Comedones
papules
pustules
nodules
cysts
scarring

Question 10

Treatment of acne

Answer 10

first line
- topical retinoids, topical benzoyl peroxide, topical ABs

second line
- oral Abs

Refer for oral retinoids if fail respond to topical and oral AB >6months or if scarring acne

Question 11

symptoms of impetigo

Answer 11

vesicles
bullae
crusting
erythema
pruritus
pain

Question 12

What causes impetigo?

Answer 12

bacterial infection with Staph aureus or strep pyogenes

Question 13

Treatment of impetigo

Answer 13

superficial; topical ABs
widespread; oral ABs
Deep soft tissue; parenteral Abs

Neonates; MRSA suspected - parenteral vancomycin

Question 14

symptoms of chicken pox

Answer 14

fever
malaise
vesicular rash
pruritus

“dew drops on a rose petal”

Question 15

Treatment of chicken pox

Answer 15

usually supportive care

antiviral if at risk of severe

Question 16

symptoms of shingles

Answer 16

localised pain in a dermatome
pruritus
rash
fever
headache
malaise

Question 17

Treatment of shingles

Answer 17

oral antiviral therapy
analgesics and calamine lotion

If eye involvement; PROMPT referral to opthalmology

Question 18

What causes irritant contact dermatitis?

Answer 18

friction
environmental
chemicals

Question 19

What causes allergic contact dermatitis?

Answer 19

Type IV hypersensitivity, 48 - 72hrs after exposure

Question 20

Symptoms of contact dermatitis

Answer 20

rash

pruritus

Question 21

Diagnosis in contact dermatitis

Answer 21

patch testing to determine if allergic

Question 22

Treatment in irritant contact dermatitis

Answer 22

moisturisers

topical corticosteroids

Question 23

Treatment in allergic contact dermatitis

Answer 23

FIRST topical corticosteroids
SECOND topical calcineurin inhibitors
THIRD phototherapy

Question 24

symptoms of molluscum contagiosum

Answer 24

smooth, pearl-like papules; umbilicated

erythema

Question 25

Treatment of molluscum contagiosum

Answer 25

usually none in children and immunocompetent adults if immunocompromised or affecting person - curettage

Question 26

symptoms of staph scalded skin syndrome

Answer 26

``` fussiness, irritability tiredness fever red skin blisters ```

Question 27

Diagnosis staph scalded skin syndrome

Answer 27

may involve skin biopsy | cultures

Question 28

Treatment of staph scalded skin syndrome

Answer 28

admission IV fluids IV Abs skin creams, ointments and bandages

Question 29

symptoms of SJS and TEN

Answer 29

rash blisters including mucosal involvement Nikolsky's sign pain

Question 30

Diagnosis of SJS and TEN

Answer 30

skin biopsy --> detachment of epidermis blood cultures -ve FBC

Question 31

Treatment of SJS and TEN

Answer 31

withdraw causative agent dressing, topical antibacterial agents, emollients opthalmogical examination fluids; oral or IV analgesics; NSAIDs last resort and paracetamol can cause

Question 32

DRESS symptoms

Answer 32

rash fever lymphadenopathy inflammation of liver/lung/heart

Question 33

treatment of DRESS

Answer 33

cessation causative medicines supportive care systemic treatment for symptom relief

Question 34

describe seborrheic keratoses

Answer 34

benign skin tumour 4th-5th decade well circumscribed, warty, stuck on

Question 35

Treatment seborrheic keratoses

Answer 35

usually none unless symptomatic irritated/itching; corticosteroids raised; curettage flat; cryotherapy

Question 36

describe melanoma

Answer 36

malignant tumour of melanocytes

Question 37

Symptoms of melanoma

Answer 37

``` Asymmetrical Border irregularity Colour change Diameter >6mm Evolution ```

Question 38

treatment of melanoma

Answer 38

surgical excision; if unacceptable then imiquimod breslow <1mm, >4mm - surgical excision Metastatic - surgical excision regional lymph nodes

Question 39

Describe squamous cell carcinoma

Answer 39

malignant proliferation atypical keratinocytes precursor; actinic keratoses

Question 40

Treatment of squamous cell carcinoma

Answer 40

destructive/topical therapies - cryotherapy, curettage, photodynamic - imiquimod Surgical excision radio/chemo for metastatic

Question 41

Symptoms of basal cell carcinoma

Answer 41

pearly white papulo-nodules Previous - solar damage - UV exposure

Question 42

Treatment basal cell carcinoma

Answer 42

conventional surgery curettage ± cautery radiotherapy if reluctant to have surgery; cryotherapy, imiquimod

Question 43

Rosacea symptoms

Answer 43

central face; nose, chin, cheeks, forehead flushing eryhtema papules and pustules telangiectasias

Question 44

Pityriasis rosea symptoms

Answer 44

acute, self limiting inflammatory eruption single larger lesion; herald patch followed by smaller papulosquamous oval lesions

Question 45

Treatment of pityriasis rosea

Answer 45

emollients | antihistamines