Acne/random skin stuff

Question 1

Open comedones are called?

Answer 1

blackheads

Question 2

Closed comedomes are called?

Answer 2

whiteheads

Question 3

in acne - causative bacteria which colonizes in hair follicle?

Answer 3

Propionobacterium acnes

Question 4

Risk factors for acne ?

Answer 4

Age 12-24
FHx
Greasy skin
Endocrine stuff: PCOS, hyper androgenism

Question 5

Agg factors for acne ?

Answer 5

Stress
sweating
PMS

Question 6

acne distribution?

Answer 6

face chest upper back

Question 7

chronic acne complications ? (2)

Answer 7

scars:
atrophic (ice pick scars)
hypertrophic (keloid scars)

skin hyperpigmentation

Question 8

Acne severity:

if scattered comedomes, papules and pustules?

Answer 8

MILD

Question 9

acne severity:

If numerous papules, pustules and mild atrophic scarring

Answer 9

MODERATE

Question 10

acne severity:

Numerous papules, pustules, mild atrophic scarring, cysts, nodules and significant scarring

Answer 10

SEVERE

Question 11

Acne treatment:

If mild - T?

Answer 11

Topical therapy only:
Retinoid + Benzylperoxidase +/- antibiotic
(erythromycin or clindamycin)

Question 12

moderate acne - T?

Answer 12

Topical therapy + oral antibiotic

Erythromycin or oxytetracycline or lymecycline

Question 13

Tetracycline ABs are 1st line in moderate acne - when would you not use these however ?

Answer 13

If pregnant or <12 y/o

Question 14

If pregnant/ <12y/o and need oral AB for moderate acne - use what ?

Answer 14

erythromycin

Question 15

acne treatment option in women alone who want contraception?

Answer 15

COCP

Question 16

Severe acne treatment ?

Answer 16

Topical therapies + isotretinoin (roaccutane)

Question 17

topical retinoid side effects?

Answer 17

stinging, irritation and erythema

Question 18

cautions with topical retinoids?

Answer 18

should use at night

dont use in pregnancy

Question 19

side effects of benzyl peroxidase? also does what which is annoying?

Answer 19

erythema and peeling

can bleach your clothes

Question 20

oral ABs side effects?

Answer 20

GI upset, thrush, heaptitis

Question 21

duration of treatment with oral ABs?

Answer 21

3-6 months with 80% seeing response by 6 mths. NEED to continue topical therapy when taking

Question 22

isotretanoin/roaccutane side effects?

Answer 22

dry skin/lips, depression, hepatitis, TERATOGENIC, headaches

Question 23

When starting roaccutane/isotretinoin patient must be on what if female?

Answer 23

contraception prior to starting therapy and needs pregnancy tests during duration of use

Also need LFT FBC and lipids checked regularly

Question 24

dont give isotretinoin/roaccutane along with what- because risk of IIH?

Answer 24

tetracyclines

Question 25

woman aged 30-40 with facial flushing triggered by alcohol and develops rash on nose cheeks chin and forehead (sparing of naso labial folds)?

Answer 25

acne rosacea facial flushing can occur long before onset of rash

Question 26

triggers for acne rosacea?

Answer 26

alcohol, hot drinks, spicy food, stress

Question 27

acne rosacea morphology?

Answer 27

erythema with papules and pustules

Question 28

2 main complications of acne rosacea?

Answer 28

telangectasia | rhinophyma

Question 29

1st line treatment of acne rosacea?

Answer 29

topical metronidazole

Question 30

2nd line treatment for acne rosacea? | 3rd line?

Answer 30

topical therapies + oral ABs (doxycycline/oxytetracycline) | 3rd line = isotretanoin

Question 31

if telangectasia/rhinphyma developed due to acne rosacea - treatment ??

Answer 31

laser therapy

Question 32

Post viral rash, most commonly seen in teenagers and young adults. Sudden onset over a few weeks, began with oval shaped patch on trunk (large) and then smaller oval shaped lesions developed on the trunk and extremities?

Answer 32

Pityriasis rosea

Question 33

Pityriasis rosea (spontaneous inflammatory rash) (post viral) first presents with what lesion?

Answer 33

Herald patch

Question 34

Herald patch - describe?

Answer 34

Large oval lesion erythematous and scaly on trunk or neck and is larger than sunsequent developing lesions

Question 35

following herlad patch subsequent rash in pityriasis rosea described as having what appearance ?

Answer 35

christmass tree appearance smaller oval shaped scaly lesion on trunk and extremities - spread out along skin cleavages (tree appearnace)

Question 36

pityriasis rosea treatment ?

Answer 36

Nil self limiting (can give emoillients and anti histamines for symptoms)

Question 37

Intensly itchy purple flat topped papules/plaques that are rhomboid/polyangular shaped +/- white lacy markings that develop on the flexor surfaces of wrist/forearm ankles, legs and oral mucosa?

Answer 37

Lichen planus

Question 38

white lacy markings seen in rash of lichen planus?

Answer 38

wickmans striae

Question 39

oral lesions seen in lichen planus?

Answer 39

lacy white lesions on inside of cheek

Question 40

lichen planus ass with what condition?

Answer 40

Hep C

Question 41

where else can lichen planus develop typically ?

Answer 41

sites of trauma (koebners)

Question 42

Lichen planus management?

Answer 42

topical steroid + anti histamine

Question 43

high temperature and widespread maculopapular rash?

Answer 43

roseola

Question 44

widespread maculopapular rash no fever ? | grey/white mucosal spots in mouth - koplicks spots that develop before the rash

Answer 44

measles

Question 45

"Target shaped" lesions (annular/ring shaped macules that are raised with a red rim and red centre and then a wedge of normal skin inbetween) - Dx?

Answer 45

erythema multiforme

Question 46

Erythema multiforme can be present in minor or major form. major form considered to be what?

Answer 46

SJS (steven johnston syndrome) or TEN (toxic epidermal necrolysis) erythem multiforme major (mucosal involvement)

Question 47

infective causes of erythema multiforme?

Answer 47

herpes simplex, mycoplasma, hep B, EBV, CMV

Question 48

drugs that can cause erythema multiforme?

Answer 48

thiazide diuretics, anti-malarials, sulphonylureas, penicillins, allopurinol

Question 49

management of erythema multiforme?

Answer 49

supportive care + treat underlying cause

Question 50

SJS and TEN variants of same disease: a) if less than 10% of skin involved - Dx ? b) if more than 30% of skin involved - Dx>

Answer 50

SJS TEN

Question 51

What is SJS/TEN?

Answer 51

Potentially life threatening condition - widespread erythema and blistering of the skin and mucosal surfaces

Question 52

what can happen to the blisters in SJS/TEN?

Answer 52

they can merge, necrose and large sheets of skin can be lost

Question 53

most common causes of SJS/TEN?

Answer 53

most commonly = drug reactions Penicillins, NSAIDs, anti-convulsants (lamotrigine, valproate)

Question 54

management of SJS/TEN?

Answer 54

cessation of causative drug supportive care emoillients IV Ig