-

Question 1

What is a term that describes a appearance of hair on a Nevus

Answer 1

Hypertrichosis

Question 2

Most important prognostic factors in melanoma?

Answer 2

1. Breslow thickness (most important prognostic factor)
2. Ulceration
3. Mitotic index
4. Sentinal lymph node biopsy (if Breslow is more than 1mm)

Question 3

Nikolky’s sign?

Answer 3

top layers of the skin slip away from the lower layers when rubbed, blisters and erosions appear when the skin is rubbed gently. Positive in Pemphigus Vulgaris.

Question 4

Treatment of neonatal herpes?

Answer 4

high dose intravenous acyclovir (20mg/kg 3 times daily) for 3 weeks

Question 5

How do we diagnose HSV?

Answer 5

• Clinical
  • Tzanck smear (Fast, cheap, multinucleated giant cells)
  • PCR (Gold standard in HSV encephalitis, CSF, vesicle fluid)
  • Viral culture (Takes time 2-5 days, accurate)

Question 6

Treatment of erythema multiforme?

Answer 6

Treatment:
1.Topical steroids and antihistamines (itchy!!)
2. Acyclovir suppressive therapy in reccurent cases

Question 7

How do we diagnose VZV

Answer 7

Clinical
• Tzanck smear
• PCR (vesicle fluid)
• Viral culture
• Serology (IgG/IgM):
• In pregnant women
• Retrospective diagnosis of varicella in immunocompetent • Before immunosuppressive therapy

Question 8

Treatment of zoster?

Answer 8

800mg 5x/day within 3 days of rash po (old age / pregnant)
800mg 5x/day within 7 days of rash po (ophthalmic)
10mg/kg, 3x/day as soon as vesicles appear iv (immunocompromised)
For at least 5 days.

Question 9

“dew drops on a rose petal” describes which rash?

Answer 9

Scattered vesicular rash of chickenpox

Question 10

Prophylaxis of VZV?

Answer 10

Immunization – live attenuated vaccine:
• Infants12monthsand15months
• Adults60yearsold
• Seronegativehealthcareworkers&othercontactsof
immunocompromised patients within 5 days of exposure (post exposure prophylaxis)
VZIG - high risk contacts (10 days of exposure): • Immunocompromised
• Pregnant women • Neonates

Question 11

Treatment of molluscum?

Answer 11

• NO Treatment: spontaneous remission in 6-9 months
• Curettage/ Cryotherapy/ electrocautery/ laser
• Imiquimod

Question 12

What stain do we use for molliscum after skin biopsy and what do we find under the microscope?

Answer 12

Giemsa stain, molluscum bodies

Question 13

Generalized warts. What do we suspect?

Answer 13

Defective skin barrier -> AD
Immunocompromised-> HIV

Question 14

How to diagnose HPV wart?

Answer 14

Clinical
PCR
Skin biopsy (MOST ACCURATE)

Question 15

Management of pyoderma gangrenosum

Answer 15

Refer to dermatology urgently
Topical and systemic steroids

Question 16

Management of folliculitis declavans?

Answer 16

• Topical antibiotics
• Oral antibiotics such as
  (minocycline, tetracycline, rifampicin, clindamycin)
• Severe forms oral corticosteroid may be necessary.
• Oral isotretinoin can result in long-term remissions in
  some patients.

Question 17

Treatment of LP?

Answer 17

TOPICALS:
- Potent topical steroids
- Topical calcineurin inhibitors, pimecrolimus cream
- Topical retinoids
- Intralesional steroid injections

SYSTEMIC:
- steroids
- hydroxychloroquine
- phototherapy
- acitretin (erosive LP to avoid progression to SCC)

Question 18

Positive koebnerization in which diseases?

Answer 18

Viral warts (auto inoculation)
Lichen planus
Psoriasis
Vitiligo

Question 19

Management of Pityriasis rosea?

Answer 19

Management :
• General advice
• Rash clears up in about six to twelve weeks
• shower with plain water and bath oil, aqueous cream,
• Apply moisturising creams to dry skin.
• Expose skin to sunlight cautiously (without burning).

-oral acyclovir
- topical steroids may reduce itching
- extensive cases: phototherapy.

Question 20

Management of nappy dermatitis due to Candidiasis?

Answer 20

Stop the use of the highly potent corticosteroid
• In acute phase: mild corticosteroid
• Add topical imidazole cream for candida infection
• Educate the mother on how to change her daughter’s diapers

Select a larger size diaper to reduce friction
• Wash hands before and after changing the nappies
• Diapers should be changed once wet or soiled
• Gently clean the baby’s skin with water and a soft
cloth
• Wet wipes are convenient but expensive and can lead
to contact allergy
• Pat the skin dry gently
• Allow the skin to air dry
• Apply emollients containing zinc oxide (barrier
cream)

Question 21

Treatment of seborrheic dermatitis?

Answer 21

• Antifungal shampoo
• Corticosteroid scalp application
• Topical steroids
• Oral ketoconazole/itraconazole

Question 22

D.D of a hypopigmented lesion?

Answer 22

• Pityriasis alba (ill-defined borders) WOOD’S LIGHT: NO FLUORESCENCE
• Post inflammatory hypopigmentation (history of other skin lesions preceeding the appearance of the spots.)
• Vitiligo (depigmented milky, white macules and patches) WOOD’S LIGHT: BLUE WHITE FLUORESCENCE
• Tinea versicolor (more sharply demarcated/ may coalesce.) WOOD’S LIGHT: ORANGE/ YELLOW FLUORESCENCE
• leprosy

Question 23

D.D of HAND DERMATITIS

Answer 23

Infectious -> fungal
Exogenous -> irritant or contact dermatitis
Endogenous -> AD/ psoriasis

Question 24

WHAT DO WE USE TO DIAGNOSE ALLERGIC CONTACT DERMATITIS?

Answer 24

Patch testing!!!!

Question 25

Blue white veil on dermoscopy- associated with?

Answer 25

Melanoma