5&7 Dermatology

Question 1

Dermatitis ab igne management

Answer 1

1. Remove source of heat
2. If pre-cancerous, 5-fluorouracil cream (BD, 3/52)
3. If unaesthetic, tretinoin

Question 2

Psoriasis S&S

Answer 2

Psoriasis

1. Extensor distribution
2. Red/flaky patches (high turnover)
3. Itchiness or soreness

Question 3

Psoriasis Lifestyle Mx?

Answer 3

1. Smoking and alcohol
2. Weight
3. Trigger avoidance
4. Stress reduction

Question 4

Psoriasis medical mx

Answer 4

1. Emolients
2. CTS - moderate or potent
3. Vitamin D BD

Question 5

Psoriasis follow-up

Answer 5

Psoriasis follow-up

1. 4 week review
2. Risk for CVD

Question 6

Skin DDs - Psoriasis vs Eczema

Answer 6

1. Psoriasis starts later on

2. Psoriasis is extensor

Question 7

Explaining Acne

Answer 7

1. Not a disease - but manageable physiological reaction
2. Underlying diseases eg. PCOS
3. Generally passes at end of puberty

Question 8

Managing acne

Answer 8

1. Don’t overtreat

2. Topical retinoid
	Tretinoin topical (0.01%-0.1%)
	Adapalene topical (0.1%)

3. Topical benzoyl peroxide
   1-10%
4. Topical Antibiotics
   Clindamycin 1% foam
   Dapsone 7.5% BD
   Erythromycin 2% BD
5. Oral ABx
   Tetracycline 250-500mg
   Minocycline 50-100mgSarecycline 60-150mg
6. Oral retinoid
   Isotretinoin 0.5-1mg/kg/day
7. Oral CST
   Prednisolone 40-60mg OD

Question 9

Eczema Mx

Answer 9

Eczema

1. Avoid dryness
   Emolients
2. Topical CST
   Hydrocortisone (0.2%-2.5%)
   Prednisolone
3. Anti-histamines for itching
4. PO immunosupression
   Prednisolone 5-60mg
   Ciclosporin 2.5-5mg/kg/day
5. ABx
   Topical
   Oral
   Chlorhexadine wash

6. Topical Calcineurin inhibitor
	Tacrolimus topical (0.03-0.1%)

Question 10

Cellulitis

- Mx

Answer 10

Cellulitis management

1. Flucloxacillin (500mg QDS /5/7)
2. Clarithromicin (500mg BD 5/7)
3. Doxycycline (200mg BD, OD for 5/7)
4. Erythromycin (500mg QDS 5/7)

Question 11

Contact dermatitis

- Mx

Answer 11

Contact dermatitis Mx

1. Topical CST
   - Hydrocortisone
2. Topical CI
   - Tacrolimus
3. Phototherapy
   - BUVB and PUVA
4. Immunomodulation
   - Azathioprine
   - Ciclosporin

Question 12

BCC

- S&S

Answer 12

BCC S&S

1. Risk factors
   - Sun/UV/X-Ray
   - Transplant
   - Childhood cancer, xeroderma
2. Papules
   - Telangiectasis
3. Plaques, nodules, tumours
   - Rolled Borders
4. Small crusts/scabs
   - Non-healing wounds
5. Pearly papules/plaques

Question 13

BCC

- Mx

Answer 13

BCC Mx

1. Surgery
   - Conventional or Mohs
2. Curettage/biopsy
3. Radiotherapy

Question 14

SCC

- S&S

Answer 14

SCC S&S

1. Risk factors
   - Previous
   - Sun damage
2. Tumours
3. Bleeding and crusting
4. Non-healing wounds
5. Papules/plaques
   - Flesh coloured
   - Fungating/exophytic

Question 15

SCC Mx

• SCC IS
• Invasive SCC

Answer 15

SCC Mx

SCC in Situ:

1. Destruction
   - Cryo, electro, photo, fluorouracil
2. Topical
   - Fluorouracil
   - Imiquimod
3. Surgery
   - Conventional
   - Mohs
4. Radio

Invasive SSC:

1. Surgery
   - Conventional/Mohs
2. Radio
3. Chemo
   - Cemiplimab
   - Pembrolizumab