Acne, Warts, Urticaria, Skin caner, Sunscreen, Fungal

Question 1

Acne grades 1, 2, 3, 4

Answer 1

Comedones, papules, pustules, nodules/cysts

CPPN

Question 2

How to treat grade 4 acne?

Answer 2

Topical retinoid or benoyl peroxide at night, higher strength than used in grade 2/3

PLUS

Oral AB for 3-6 months (Doxy, minocyclin
OR the pill for females

Systemic retinoid as last line

Question 3

What are some side effects of systemic retinoids?

Answer 3

Tetrogenic
Dryness (Lips, hands, nose)
Increase sensitivity to the sun
Contraindicated with tetracyclines

Question 4

How do retinoids work for acne?

Answer 4

Activates retinoid acid receptor which causes:

1. transcription in genes that cause differentiation, leads to normalisation of keratinocyte process = reduction in blockage in sebaceous gland = reduce p acne
2. Reduce sebocyte number and reduced sebum secretion = reduce acne

Question 5

How does the pill help with acne?

Answer 5

Cyproterone: reduces activation of androgen receptor
Ethinyloestradiol: activates oestrogen receptor which leads to a reduced androgen production by ovaries and adrenals

Question 6

What virus are warts caused by?

Answer 6

Human papilloma virus

Question 7

Tinea corporis

Answer 7

Trunk and limbs

Question 8

Tinea cruis

Answer 8

Groin

Question 9

Tinea Manuum

Answer 9

Hands

Question 10

5 types of topical imadazoles

Answer 10

Bifonazole
Clotrimazole
Econazole
Ketoconazole 
Miconazole

Question 11

Oral therapy for tinea?

Answer 11

1. Griseofulvin
2. Itraconazole
3. Fluconazole
4. Terbinafine

Question 12

When is oral therapy used for tinea?

Answer 12

When tinea is in hair bearing areas, palms and soles
If widespread
Unresponsive to topical tx
Recurrent

Question 13

Three common skin cancers?

Answer 13

1. Basal cell carcinoma
2. Squamous cell carcinomas
3. Melanoma

Question 14

Four precursors and lesions indicating risk of skin cancer?

Answer 14

1. Solar keratoses
2. Melanocytic naevi
3. Dysplastic naevi
4. Seborrhoeic keratoses

Question 15

Which is stronger UVA or UVB?

Answer 15

UVA- Penetrates deeper into the skin and causes long term damage (wrinkles, discolouration, sagging)

UVB- Reaches the top layer of the skin, cause of tanning and sunburn

Question 16

The 5 sun protection strategies?

Answer 16

SLIP
SLOP
SLAP
SEEK 
SLIDE

Question 17

What are the chemical and physical barriers sunscreens provide?

Answer 17

Chemical: Absorbs part or all of UV rays (Aminobenzoates, camphor derivatives, cinnamates)
Physical: Reflects or scatters part or all of UV rays away from the skin (Zinc oxide)

Question 18

What is Sun protection factor (SPF)?

Answer 18

Grades the ability of a sunscreen to filter UV

Ratio of UV radiation dose required to produce minimum erythema on skin thats has been protected to unprotected skin under same conditions
SPF30 = 30 times as much UVB needed to produce minimal erythema on skin protected by product compared to unprotected skin

Question 19

What is a broad spectrum sunscreen?

Answer 19

Filter UVB and UVA