Framework for dermatology

Question 1

List 5 key questions to establish dermatological history

Answer 1

TRUE age of onset
evidence of contagion
ectoparasiticidal regime
distribution of lesions/ pruritus
did pruritus start before or after onset of lesions

Question 2

what does a bilaterally symmetrical lesion generally suggest

Answer 2

most likely something that starts internally then manifests itself on the skin e.g. autoimmune disease, endocrinopathies

Question 3

what does asymmetric, irregular distribution lesion disruption suggest

Answer 3

more likely something from the environment

Question 4

What are the first things to rule out in derm case

Answer 4

rule out ectoparasites
rule out microbial infections

Question 5

Describe the diagnostic tests used for ectoparasites

Answer 5

into liquid parafin - no stain
low objective (x4-10) on microscope
acetate tape, coat combing, skin scap (deep and superficial)

Question 6

How can we rule out microbial infection in derm causes

Answer 6

cytology - in-house is quick and cheap

Question 7

what sample are you going to do with a wet/greasy skin lesion

Answer 7

if accessible- direct impression smear
if inaccessible- indirect impression smear

Question 8

what sample are you going to do with a dry skin lesion

Answer 8

stained acetate tape strip

Question 9

List 5 things to consider when picking dermatological therapeutics

Answer 9

efficacy
physical feasibility
safety
antimicrobial stewardship
cost