Dermatology

Question 1

What are the pathogenic factors seen in acne?

Answer 1

Abnormal keratinisation of the follicular epithelium
Increased sebum excretion
Infection with gram positive rod propionibacterium acnes

Question 2

What are the 11 different types of acne?

Answer 2

Comedonal acne
Papulopustular acne
Acne fulminans
Acne conglobata
Acne excoriee
Infantile acne
Mechanical acne
Chloracne
Cosmetic acne
Post adolescent acne 
Endocrine causes

Question 3

Conditions associated with seborrheic dermatitis

Answer 3

HIV

Parkinsons

Question 4

Causes of nail destruction

Answer 4

Psoriasis
Lichen planus
SCC
Melanomas

Question 5

Causes of nail pitting

Answer 5

Psoriasis
Eczema
Lichen planus
Alopecia areata

Question 6

Causes of onycholysis

Answer 6

Psoriasis
Dermatophyte infection
Trauma
Thyroid disease

Question 7

What is Hutchinson’s sign?

Answer 7

Pigmentation in the nail folds- spreading from the nail into the skin around the nail- melanoma

Question 8

Cause of green nail

Answer 8

Pseudomonas aeruginosa

Question 9

Most likely cause of acute paronychia

Answer 9

Staph

Question 10

Name two physical signs that may be present in onychomycosis

Answer 10

Changes in nail colour
Separation from nail bed
Crumbling nail
Ridging

Question 11

What topical agents are effective for onychomycosis?

Answer 11

NONE

Need systemic therapy

Question 12

Explain the pathogenesis of a myxoid cyst

Answer 12

Cystic outgrowing from the joint which can interfere with the growth of the nail

Question 13

Features of neurofibromatosis

Answer 13

Cafe au lait macules
Axillary freckling
Neurofibromas
Flexiform large subcutaneous neurofibromas
Lisch nodule
CNS tumours

Question 14

Features of tuberose sclerosis

Answer 14

Ash- leaf, oval areas of depigmentation present from birth
Shagreen patches
Angiofibromas, commonly on the face
Periungual fibromas
Seizures and cognitive impairment

Question 15

What is a shagreen patch

Answer 15

Connective tissue naevis

Question 16

A child presents with a rash in a photosensitive distribution, and proximal muscle weakness. What blood test would you perform? Is it necessary to image to look for
malignancy?

Answer 16

Dermatomyositis

Creatinine kinase

Question 17

A 50 year man presents with new onset dry scaly skin and generalised
lymphadenopathy. What diagnosis might you consider?

Answer 17

Aquired icthiosis

Look for malignancy

Question 18

A 50 year man presents with new onset dry scaly skin and generalised
lymphadenopathy. What diagnosis might you consider?

Answer 18

Aquired ichthyosis

Look for malignancy- most commonly a lymphoma

Question 19

A heliotrope rash and Gottron’s papules: what disease?

Answer 19

Dermatomyositis

Question 20

Causes of hirsuitism

Answer 20

Congenital adrenal hyperplasia
Adrenal tumours
Cushing’s syndrome
PCOS

Question 21

Name 3 local treatments for hirsuitism

Answer 21

Shaving
Waxing
Bleaching
Electrolysis
Lasers

Question 22

Causes of hypertrichosis

Answer 22

Birthmarks
Malnutrition
Anorexia nervosa
Dermatomyositis
Porphyria cutanea tarda

Question 23

Causes of telogen effluvium

Answer 23

Major life events- pregnancy

Cytotoxins

Question 24

Management of alopecia areata

Answer 24

Wait and see
Topical corticosteroid injections
Short bursts of systemic corticosteroids early in the course of the disease
Wig

Question 25

Causes of diffuse alopecia

Answer 25

``` Systemic malignancy Renal/ liver failure Hypo/ hyperthyroidism or hypopituitarism Iron deficiency Drugs: antithyroid drugs, retinoids, azathioprine ```

Question 26

Causes of scarring alopecia

Answer 26

Discoid lupus erythematosus | Lichen planus

Question 27

Types of melanoma

Answer 27

Superficial spreading Nodular Lentigo maligna Acral lentiginous

Question 28

Where does superficial spreading melanoma typically affect?

Answer 28

Arms, legs, back and chest of young people

Question 29

Where does nodular melanoma typically affect?

Answer 29

Sun exposed areas in middle aged people

Question 30

Where does lentigo maligna melanoma typically affect?

Answer 30

Chronically sun exposed areas in older people

Question 31

Where does acral lentiginous melanoma typically affect?

Answer 31

Nails, palms or soles of African Americans or Asians

Question 32

What is the typical appearance of superficial spreading melanoma?

Answer 32

Growing moles with diagnostic features

Question 33

What is the typical appearance of nodular melanoma?

Answer 33

Red or black lump or lump which bleeds and oozes

Question 34

What is the typical appearance of lentigo maligna melanoma?

Answer 34

Growing moles with diagnostic features

Question 35

What is the typical appearance of acral lentiginous melanoma?

Answer 35

Subungal pigmentation (Hutchinson's sign) or on palms or feet

Question 36

What are the main diagnostic criteria for melanoma?

Answer 36

Change in size Change in shape Change in colour

Question 37

What are the minor criteria for melanoma?

Answer 37

Diameter > 6mm Inflammation Oozing or bleeding Altered sensation