Dermatology Pathology

Question 1

Define Herpes Simplex Virus.

Answer 1

• infection caused by herpes virus

Question 2

List symptoms of herpes simplex virus.

Answer 2

• coldsores

- genital skin lesions

Question 3

How would you treat herpes simplex virus?

Answer 3

• treat with aciclovir

Question 4

Describe herpes zoster virus.

Answer 4

• virus that causes chickenpox and shingles

- shingles occurs when HZV reappears in the dorsal root or cranial ganglia

Question 5

Describe the presentation of herpes zoster virus.

Answer 5

• eruptions of macules and papules

- in severe cases there is a dermatomal, unilateral pattern with severe pain and facial palsy

Question 6

How would you treat herpes zoster virus?

Answer 6

• treat with aciclovir and vaccines in the elderly

Question 7

Describe scabies.

Answer 7

• parasitic infestation by sarcoptes scabei spread by prolonged close contact

Question 8

Describe the presentation of scabies.

Answer 8

• itchy rash that resembles eczema

- small papules, vesicles and pustules usually appear in hands, wrist and axillae

Question 9

How would you treat a scabies infestation?

Answer 9

• topical scabicide applied overnight

Question 10

Define cellulitis.

Answer 10

• infection of the dermis and subcutaneous tissues respectively

Question 11

Describes the presentation of cellulitis.

Answer 11

• tender, confluent areas of inflammed skin
• fever
• malaise
• usually starts in the legs

Question 12

How would you treat cellulitis?

Answer 12

• treat with antibiotics

Question 13

Define eczema.

Answer 13

An itchy skin condition in the last 12 months, plus three or more of;

• onset before age 2
• history of flexural involvement
• history of generally dry skin
• history of other atopic disease
• history in 1st degree relative if <4 years

Question 14

Describe the presentation of eczema.

Answer 14

• itchiness
• scaling
• papules
• vesicles
• especially in flexural areas

Question 15

How would you investigate eczema?

Answer 15

• allergic contact patch testing

- IgG testing

Question 16

How would you treat eczema?

Answer 16

• irritant avoidance
• emolients
• topical corticosteroids

Question 17

Define Steven-Johnson Syndrome.

Answer 17

• a severe drug reaction with <10% skin detachment and one or two mucosal sites involved

Question 18

Define Toxic Epidermal Necrolysis.

Answer 18

• a severe drug reaction with >30% skin detachment

Question 19

Describe the presentation of SJS and TEN.

Answer 19

• onset usually 1-2 weeks after drug exposure
• malaise
• myalgia
• fever
• cough
• tender regions of maculopapular erythema
• mouth ulceration
• rapid confluent blistering

Question 20

How would you treat SJS and TEN?

Answer 20

• identify and stop the culprit drug

- supportive therapy

Question 21

Describe psoriasis.

Answer 21

• chronic, immune-mediated disease
• skin becomes inflammed and hyperproliferates at 10x the normal rate
• red, well-demarcated scaly plaques

Question 22

List risk factors for melanoma.

Answer 22

• high UV radiation exposure
• genetic susceptibility
• familial melanoma

Question 23

Describe the presentation of melanoma.

Answer 23

appears as a mole with;
Asymmetry 
Border uncircumscribed 
Colour changes throughout 
Diameter (>6mm)
Evolution (recent changes) 
- also important to know about oozing/bleeding
- itch
- altered sensation

Question 24

How would you treat melanoma?

Answer 24

• urgent surgical excision

- chemotherapy

Question 25

What is the most common malignant skin condition?

Answer 25

- basal cell carcinoma

Question 26

Describe the presentation of basal cell carcinoma.

Answer 26

- appears as a slowly enlarging nodule on the neck or head area - bleeds following minor trauma - doesn't heal - pearly rolled edges - central ulceration

Question 27

How would you treat basal cell carcinoma

Answer 27

- excision

Question 28

Which type of skin cancer develops keritinising squamous cells?

Answer 28

- squamous cell carcinoma

Question 29

Describe the presentation of squamous cell carcinoma.

Answer 29

- fast growing - tender - crusted - can ulcerate

Question 30

How would you treat squamous cell carcinoma?

Answer 30

- excision | - radiotherapy

Question 31

Describe sebhorrhoeic keratoses.

Answer 31

- benign lesions that may indicate an underlying malignancy (like GI adenocarcinoma)

Question 32

Describe the presentation of sebhorrhoeic keratoses.

Answer 32

- leser trelet sign - abrupt onset of widespread SKs, particularly in younger patients - large warty growths with a stuck on appearance - multiple cherry angiomas

Question 33

How would you treat sebhorrhoeic keratoses?

Answer 33

- generally left untreated | - cryotherapy and curettage if required

Question 34

Define Bowen's disease.

Answer 34

- intraepidermal squamous cell carcinoma in situ

Question 35

Describe the presentation of Bowen's disease.

Answer 35

- irregular, scaly erythematous plaque

Question 36

How would you treat Bowen's disease?

Answer 36

- cryotherapy and curettage - photodynamic therapy - imiquimod

Question 37

Define acne vulgaris.

Answer 37

- disease of the pilosebacious unit causing comedones/whiteheads and blackheads

Question 38

How would you treat acne vulgaris?

Answer 38

- retinoids - benzoyl peroxide - antibiotics - isoretinoin

Question 39

Define acne rosaria.

Answer 39

- common inflammatory facial rash, which usually occurs in mid-adult life, due to immune system

Question 40

Describe the presentation of acne rosaria.

Answer 40

- diffuse erythema, inflammatory papules and pustules that affect the face in an ace of clubs formation

Question 41

How would you treat acne rosaria?

Answer 41

- antibiotics - topical cream - tetracylines - isoretinoin

Question 42

Define impetigo.

Answer 42

- skin disease of children spread by direct contact

Question 43

Describe the presentation of impetigo.

Answer 43

- inflammed plaques with a golden, crusty surface - usually on hands or face - can be itchy

Question 44

How would you treat impetigo?

Answer 44

- fusidic acid