Dermatology

Question 1

What is eczema?

Answer 1

Inflammatory skin condition characterised by dry, pruritic skin with a chronic relapsing course

Question 2

What are some endogenous causes of eczema?

Answer 2

Atopic
Seborrheic dermatitis
Discoid
Pomphylx
Juvenile plantar dermatitis

Question 3

What is the diagnostic criteria for atopic eczema?

Answer 3

Eczema for 2 months + 2 of

• onset <2
• flexural distribution
• generally dry skin
• FH/other atopic disease

Question 4

What is the presentation of seborrheic dermatitis?

Answer 4

Usually <6 months

Scalp and proximal flexures

Question 5

What is the presentation of pomphylx eczema?

Answer 5

Palms and soles of feet

Intensely itchy

Question 6

What are some examples of exogenous eczema?

Answer 6

Allergic contact dermatitis

Irritant contact dermatitis

Question 7

What kins of reaction if allergic contact dermatitis?

Answer 7

Type 4 hypersensitivity

Question 8

What are the risk factors for eczema?

Answer 8

Age <5
FH
Atopy
Smoke exposure

Question 9

What is the presentation of eczema?

Answer 9

Pruritus
Dry skin
Erythema, scaling, vesicles, papules
Lichenification, hypo pigmentation, plaques, fissures

Question 10

What is the stepwise management of eczema?

Answer 10

1. topical emollients and steroids
2. phototherapy
3. systemic medications
4. biologics

Question 11

What are the types of topical steroid?

Answer 11

1. hydrocortisone
2. eumovate
3. betnovate
4. dermovate

Question 12

What systemic medications can be used for eczema?

Answer 12

Methotrexate

Ciclosporin

Question 13

What is psoriasis?

Answer 13

Chronic immune mediated disease

Increased production of skin cells via autoimmune reaction, leading to build up of skin

Question 14

What are the types of psoriasis?

Answer 14

1= familial, early onset, common
2= related to other autoimmune conditions and environment, older onset

Question 15

What is the histology of psoriasis?

Answer 15

Hyperkeratosis
Dilated dermal capillaries
Neutrophils and T cell infiltration

Question 16

What are the clinical features of psoriasis?

Answer 16

Sharply demarcated, circumscribed erythematous plaques- scaly, white superficial layer, erythematous
Often symmetric

Question 17

What are the classic psoriasis sites?

Answer 17

Extensor surfaces
Scalp
Nail changes

Question 18

What type of psoriasis if often seen in children and adolescents?

Answer 18

Guttate psoriasis

Multiple pink papules with fine scale

Question 19

What is the stepwise management of psoriasis?

Answer 19

1. topical emollients and vit D analogues
2. phototherapy
3. Systemic medications
4. Biologics

Question 20

What systemic medications can be taken for psoriasis?

Answer 20

Methotrexate
Ciclosporin
Retinoids

Question 21

What is the management of erythrodermic psoriasis?

Answer 21

Fluids and systemic treatment

Thick great ointments and emollients

Question 22

What are molluscum contagiosum?

Answer 22

Very common

Viral

Question 23

What is the presentation of molluscum contagiosum?

Answer 23

Small raised papules
Characteristic dimple in middle
Itchy

Question 24

What are common locations of molluscum contagiosum?

Answer 24

Armpit
Behind knees
Groin

Question 25

What is the management of molluscum contagiosum?

Answer 25

Observation- will disappear in about 18 months | If bothersome- curettage or topical destructive agents

Question 26

What is impetigo?

Answer 26

Superficial bacterial skin infection, usually caused by staph aureus

Question 27

What is the presentation of impetigo?

Answer 27

Golden crust= classic Bollous= common in <2s, systemically unwell Non bullous= systemically well, often around mouth and nose

Question 28

What is the management of impetigo?

Answer 28

Topical fusidic acid | Severe/bullous= Oral/IV flucloxacillin

Question 29

What are the complications of impetigo?

Answer 29

Easily spread | Staph scalded skin syndrome

Question 30

Who is staph scalded skin syndrome seen in?

Answer 30

Usually <5yo

Question 31

What is the presentation of staph scalded skin syndrome?

Answer 31

Generalised patches of erythema followed by formation of bull which burst Similar appearance to burns Gentle rubbing of skin causes it to peel away Systemically unwell

Question 32

What is the management of staph scalded skin syndrome?

Answer 32

IV antibiotics and fluids

Question 33

What is the chicken pox?

Answer 33

Highly contagious generalised vesicular rash caused by VZV

Question 34

What is the presentation of chicken pox?

Answer 34

Widespread erythematous raised vesicular blistering lesions- starts on trunk/face and spreads outwards over 2-5 days Fever, itch

Question 35

What is he management of chickenpox?

Answer 35

Self limiting Itch- calamine lotion, antihistamine Aciclovir if- neonate, immunocompromised, at risk of complications

Question 36

What are the complications of chickenpox?

Answer 36

Bacterial superinfection Encephalitis Shingles

Question 37

What causes hand, foot and mouth?

Answer 37

Coxsackie virus A

Question 38

What is the presentation pf hand, foot and mouth?

Answer 38

Early- URT symptoms | 1-2 days later- painful mouth ulcers, itchy blistering red spots across body

Question 39

What is the management of hand, food and mouth?

Answer 39

Resolves in 1 week-10 days | Fluids and analgesia

Question 40

What is scabies?

Answer 40

Very common and contagious parasitic mite

Question 41

What is the presentation of scabies?

Answer 41

Incredibly itchy small spots Track marks Classic location= finger web

Question 42

What is the management of scabies?

Answer 42

PErmethin cream twice, 1 week apart | Anihistamine for itch

Question 43

What is a complication of scabies?

Answer 43

Crusted scabies

Question 44

What is crusted scabies?

Answer 44

Serious scabies in immunocompromised patients | Patches of red skin that turn into scaly plaques

Question 45

What is slap cheek also known as?

Answer 45

Parovirus B19

Question 46

When is slap cheek contagious?

Answer 46

Before rash develops

Question 47

What is the presentation of slap cheek?

Answer 47

Early= mild fever, coryza and non specific symptoms | 2-5 days later= diffuse bright red rash n both cheeks

Question 48

What is the course of slap cheek?

Answer 48

Self limting | Fades over course of 1-2 weeks

Question 49

What are the complications of slap cheek?

Answer 49

Aplastic anaemia | Pregnancy complications

Question 50

What is the presentation of the measles?

Answer 50

Early= fever, coryza, conjunctivitis 2 days later= Koplik spots- greyish white spots on buccal mucosa 3-5 days later= erythematous macular rash starting on face, classically behind ears

Question 51

What is pathognomonic of measles?

Answer 51

Koplik spots- greenish white spots on buccal mucosa

Question 52

What is the management of measles?

Answer 52

Self limiting | Notifiable disease

Question 53

What is scarlet fever associated with?

Answer 53

Group A strep, usually tonsillitis

Question 54

What is the presentation of scarlet fever?

Answer 54

Red pink blotchy macular rash with sandpaper skin, starts on trunk and spreads Strawberry tongue

Question 55

What is the management of scarlet fever?

Answer 55

10 days phenoxymethylpenicillin | Notifiable disease

Question 56

What is the presentation of Rubella?

Answer 56

Mild erythematous macular rash- starts on fave and spreads to rest of body, lasts ~3 days Mild fever, jolt pain, lymphadenopathy

Question 57

What is the management of rubella?

Answer 57

Self limiting | Notifiable disease