Dermatology Pt2

Question 1

Cause & characterisation & treatment of boils:

Answer 1

Hair follicle becomes infected to produce a pus-filled lump on the skin.

Treated by drainage of pus and antibiotics.

Question 2

Most common bacterium causing boils & 2 oral antibiotics used:

Answer 2

Staphylococcus aureus

1. Fluxcloxacillin
2. Clarithromycin

Question 3

What are carbuncles?

Answer 3

Multiple boils occurring when hair follicles next to each other become infected

Question 4

What is chronic furunculosis & treatment (2)?

Answer 4

This is a condition where groups of boils occur over a period of time, either episodically or continuously

Treated by antibiotics or surgery

Question 5

What is folliculitis & treatment & main bacterium involved?

Answer 5

Inflammation of hair follicles in the skin whereby very small pustules develop at the base of the hair

Antibiotics if not resolved by itself

Staphylococcus aureus

Question 6

3 types of folliculitis:

Answer 6

1. Hot-tub folliculitis - hot water is a thriving medium for Pseudomonas species
2. Sycosis barbae - bearded area of a mans face causing burn & itching sensation when shaving
3. Gram-negative folliculitis - associated with long-term antibiotic treatment for acne

Question 7

Herpes simplex virus reactivation cause & what it causes:

Answer 7

Often when the individual is unwell or stressed

Causes sore, blistering lesions on the mucous membranes

Question 8

How is the herpes virus transmitted?

Answer 8

Through bodily fluid exchange (primarily through kissing or sex) even if the individual does not have any active lesions at the time (asymptomatic viral shedding)

Question 9

What antiviral medication can be used a treatment option for an outbreak?

Answer 9

Aciclovir

Oral herpes - topical
Genital herpes - oral

Question 10

What does varicella-zoster virus (VZV) cause (2)?

Answer 10

1. Chickenpox in childhood
2. May lie dormant in sensory nerve root an recur as shingles later in life

Itch intensely as the papules, rash, and macules start to heal.

Question 11

Symptoms of shingles (2):

Answer 11

1. Periods of flu-like illness
2. Followed by painful, blistering rash which follows the course of the cutaneous nerve across the skin

Question 12

The rash may be present for up to two weeks, but the pain may last longer than this

Question 13

Treatment, ideally early-on, for shingles to reduce duration & severity of the shingles outbreak:

Answer 13

Aciclovir

Occasionally shingles may affect the optic nerve, which is a medical emergency, and potentially requires hospital admission and consultant ophthalmology input

Question 14

Cause of warts and verrucae & characterisation:

Answer 14

Human papillomavirus (HPV)

They appear as raised, firm, skin-coloured lesions although they may also be grey or white in colour

Question 15

Treatment for warts & verrucae: (3)

Answer 15

1. Left untreated
2. Frozen with liquid nitrogen
3. Painted with salicylic acid and filed down

Immune system wil eventually fight off the infection but this can take up to two years. They’re difficult to pass on to others.

Question 16

Cause of orf:

Answer 16

Parapox virus - this infects lambs and goats

Question 17

Who are most susceptible to orf?

Answer 17

Farmers, vets, and children who bottle-feed lambs if subjected to animals grazing on pasture

Question 18

Symptoms of orf & location:

Answer 18

Small, firm, red or reddish-blue lesions develop, and will eventually form a blister tinged with blood on the fingers, hands, forearms, or face.

Question 19

No treatment for orf - it will regress within 3-6 weeks

Question 20

Treatments for fungal infections of the skin: 2 parts

Answer 20

1. Firstly, OTC topical antifungal medications
2. Followed by prescription topical / oral drugs for more severe cases

Question 21

Two OTC topical antifungals & an oral antifungal (for more severe cases):

Answer 21

Topical - clotrimazole & miconazole

Oral - fluconazole tablets

Question 22

5 diseases caused by fungal infections:

Answer 22

1. Athlete’s foot
2. Ringworm
3. Ringworm of the groin
4. Nail infections
5. Thrush

Question 23

Cause & symptoms of athlete’s foot:

Answer 23

Caused by Trichophyton rubrum - grows best in warm & moist environments

Leading to peeling, redness, itching, burning, and sometimes blisters & sores

Question 24

Treatments for athelte’s foot: (2)

Answer 24

1. Clotrimazole
2. Miconazole

Question 25

Ringworm (tinea corporis) is a fungal infection and can appear anywhere on the body. What does ringworm look like?

Answer 25

Circular, red, flat sore often accompanied by scaly skin. Outer part can be raised whilst the middle appears normal.

Question 26

Who are usually affected by ringworm of the groin and potential cause?

Answer 26

Young males who play sports commonly, cross-contamination from athlete's foot

Question 27

Two treatments of ringworm:

Answer 27

1. Clotrimazole 2. Miconazole

Question 28

Nail infections take a long time to develop, what do they look like?

Answer 28

Discoloured, crumbly, surrounding tissue may thicken

Question 29

They can be treated using either antifungal nail lacquers (such as amorolfine) or even with oral antifungal treatments, although they require treatment for many months, and are hard to cure even with sustained antifungal use.

Question 30

C. albicans is a common fungus that is often present in the mouth, stomach and skin (and vagina in females) usually causing no problems. But, what causes thrush symptoms?

Answer 30

If the person is unwell, pregnant, has diabetes, or is taking antibiotics causing the fungi to multiply

Question 31

What does thrush look like & in women?

Answer 31

Small white patches which leave a red mark when rubbed off In women, vaginal thrush can cause itchiness and a white discharge that ranges from slightly watery to thick and white

Question 32

Treatment for athlete's foot & ringworm (& groin) & thrush

Answer 32

Clotrimazole or miconazole (topical)