TREATMENTS

Question 1

psoriasis

Answer 1

emollients

• vit d analouges eg calcitriol
• coal tar
• dithranol

phototherapy
- UVB and PUVA

systemic treatments
- methotrexate

Question 2

scalp psoriasis

Answer 2

• greasy ointment
• tar shampoo
• steroids in alcohol base or shampoo
• vit d analogues

Question 3

axilla psoriasis

Answer 3

calcineural inhibitors

Question 4

chronic plaque psoriasis

Answer 4

vit d analogues

moderate - potent topical steroids can be used

Question 5

flexural psoriasis

Answer 5

mild steroid / topical cream

tacrolimus

Question 6

guttate psoriasis

Answer 6

topical therapies and UBV

Question 7

palmoplantar psoriasis

Answer 7

very potent topical steroids, tar paste or local hand / foot UBV

Question 8

atopic eczema

Answer 8

for everyone - emmolients
for itch - antihistamines
for flare - topical steroids

calcineurin inhibitors (tacrolimus) = steroid sparing agent

phototherapy (UBV)

Question 9

strengths eczema (steroids)

Answer 9

mild - hydrocortisone
moderate - betnovate, tacrolimus
severe - dermovate, UV light therapy, systemic immunosuppression

Question 10

eczema herpeticum

Answer 10

IV aciclovir

Question 11

seborrhoeic dermatitis

Answer 11

infantile cradle cap - emollients +- topical steroids

adults - emollients + topical steroid + topical antifungal (ketoconazole)
if non-responsive - oral antifungals

Question 12

venous eczema

Answer 12

compression

Question 13

PCT

Answer 13

1. treat underlying cause (alcohol, viral hep)

2. low dose of antimalarials (chloroquine) –> works by removing excess porphyrins from liver

Question 14

erythropoietic protoporphyria

Answer 14

• suncream containing zinc
• prophylactic TL-01 phototherapy using UBV lamp
• antioxidants
• 6 monthly LFTs

Question 15

acute intermittent porphyria

Answer 15

• high carbohydrate if drug caused

acute attack = hematin and heme arginate

Question 16

polymorphic light eruption

Answer 16

• topical steroids

- desensitising using UVB prior to sunlight use

Question 17

dermatophyte infections

Answer 17

small areas

• clotrimazole cream
• topical nail pain - amorolfine

extensive

• terbinafine
• itraconazole

Question 18

candida skin infections

Answer 18

clotrimazole cream

oral fluconazole

Question 19

pityriasis vesicolour

Answer 19

• kerconazole

- green under woodlamp

Question 20

scabies

Answer 20

malathion lotion or permethrin

Question 21

lice

Answer 21

malathion lotion

Question 22

acne vulgaris

Answer 22

topical

• benzyl peroxide
• topical vit A derivatives
• topical antibiotics

systemic

• antibiotics eg doxycycline for 6 months
• isotretinoin

Question 23

mild acne vulgaris

Answer 23

topical therapy only (retinoid+ BPO / antibiotic eg erythromycin or clindamycin)

Question 24

moderate acne vulgaris

Answer 24

topical therapy + oral antibiotic (erythromycin/ clindamycin) + contraceptive pill

Question 25

severe acne vulgaris

Answer 25

topical therpaies | isotretinoin

Question 26

rosacea

Answer 26

1. topical therapy - metronidazole / ivremectin (to remove mite) 2. + oral therapy - tetracycline 3. isotretinoin

Question 27

potyriasis rosea

Answer 27

emollients and antihistamine

Question 28

tuberose scleorosis

Answer 28

mTOR inhibitors

Question 29

bullous pemphigoid

Answer 29

- systemic steroids | - topical treatments - emollients, topical steroids, topical antiseptics

Question 30

pemphigus vulgaris

Answer 30

- tetracycline local disease - topical steroids + topical anaesthetics systemic disease - high dose steroids + immunosuppressive +- rituximab

Question 31

chickenpox

Answer 31

dont take ibroprufen

Question 32

shingles

Answer 32

no treatment | - acyclovir to speed up

Question 33

herpes simlex virus

Answer 33

- analouge of guanosine | - oral aciclovir

Question 34

erythema multiforme

Answer 34

if recurrent, aciclovir

Question 35

dermatitis herpetiformis

Answer 35

- gluten free diet | - dapsone (rapid relief from itching and blistering

Question 36

warts

Answer 36

- topical salicylic acid + mechanical pairing

Question 37

syphilis

Answer 37

penicillin

Question 38

lyme disease

Answer 38

- doxycyline or amoxicillin

Question 39

necrotizing fascitis

Answer 39

- urgent surigcal debridement + antibiotics (group A = clindamycin + penicillin)

Question 40

impetigo

Answer 40

localised - fusidic acid MRSA - mupirocin widespread / bullous - fluclox

Question 41

SSSST

Answer 41

fluclox

Question 42

cellulitis

Answer 42

1. fluclox 2. doxycyline 3. IV fluclox / vancomycin if allergic

Question 43

erysipelas (superficical cellulitis)

Answer 43

fluclox

Question 44

folliculitis

Answer 44

topical antiseptic and loose clothing

Question 45

boils / furnuncles

Answer 45

isolated boils - hot bathing alone widespread - fluclox PVL - rifampicin / clindamycin larger boils - incision and drainage

Question 46

Neurofibromatosis T1

Answer 46

MEK inhibitors

Question 47

actinic keratosis

Answer 47

topical 5-flurouracil cream | imiquimoid cream

Question 48

bowen's disease

Answer 48

surgical - cryosurgery, cutterage, excision | medial - phododynamic therapy, topical imiquimoid, 5-FU

Question 49

melanoma

Answer 49

- urgent excision biopsy / chemo advanced - dasatinib + imatininb = target c-kit - vemurafenib = target BRAF - trametinib = targets MEK

Question 50

BCC

Answer 50

- excision + cryotherapy superficial BCCs - topical flurouracil or imiquimoid morphoeic / on nose - mohs surgery

Question 51

SCC

Answer 51

- excision with minimal margin of 5mm

Question 52

leg ulcer

Answer 52

- non-adherent dressing - desloughing agent eg hydrogel - compression stockings - 4 layer compression bandaging

Question 53

T1 allergy

Answer 53

- adreanline autoinjector (300 in adults, 150 in children)