Management of big conditions

Question 1

SJS / TEN

Answer 1

high dose steroids/ antihistamines
IV immunoglobulins
Anti-TNF therapy
Cyclosporin

Supportive (analgesia, hydration, wound care)

Question 2

DRESS

Answer 2

Systemic steroids
Immunoglobulins

Supportive/symptomatic

Question 3

Psoriasis

Answer 3

Emollients
Vitamin D3 analogues
Topical steroids
Tar creams
Salicylic acid
Dithranol
UVB phototherapy
Retinoids
Cyclosporin/methotrexate
Anti-TNF therapy

ERYTHRODERMIC: admit, fluid balance, thick greasy ointments/ emollients

Question 4

Eczema

Answer 4

Emollients/ soap substitutes
Intermittent topical steroids
Antihistamines
Antimicrobials
Topical calcineurin inhibitors
UV light
Cyclosporin/ methotrexate

Question 5

Acne vulgaris

Answer 5

1st: Benzoyl peroxide
2nd: Oral antibiotics
3rd: Topical retinoids (alter follicular keratinisation)
4th: Oral isoretinoin (decrease sebum excretion)

Topical antibiotics (erythromycin)
Azelaic acid
Combined OCP

Question 6

Rosacea

Answer 6

Metronidazole cream/gel
Oral tetracyclines
Surgery (rhinophyma)

Question 7

Bowen’s disease

Answer 7

Cryotherapy
Curettage
Imiquimod cream

Question 8

Basal cell carcinoma

Answer 8

Excision (Moh’s surgery)
Curettage
Vismodegib

Question 9

Squamous cell carcinoma

Answer 9

excision +/- radiotherapy

Question 10

Malignant melanoma

Answer 10

Urgent surgical excision
chemotherapy
immunotherapy

Question 11

Mycosis fungoides / sezary syndrome

Answer 11

Topical steroids
Interferon
Bexarotene
low dose methotrexate
chemotherapy
photochemotherapy
extracorporeal photopheresis
total skin electron beam therapy
localised radiotherapy
bone marrow transplantation