Advanced Dermatology

Question 1

Mild acne should be treated by:

Moderate acne should be treated by:

Answer 1

mild = Pharmacist
moderate = GP.

Question 2

NICE guidance on Eczema treatment. For CLEAR eczema:

Answer 2

Emollients

Question 3

NICE guidance on Eczema treatment for MILD eczema

Answer 3

Emollinets

Mild topical corticosteroids

Question 4

NICE guidance on Eczema treatment for MODERATE eczema

Answer 4

Emollinets
Topical corticosteroids
Topical calcineurin inhibitors
Bandages

Question 5

NICE guidance on Eczema treatment SEVER asthma

Answer 5

Emollients
Topical corticosteroids
Topical tarcrolimus
Phototherapy
Bandages
Systemic therapy

Question 6

How to detect a difference between viral and bacterial infection of acne:

Answer 6

VIral fluid is clear
Bacterial fluid is white-yellow ish
Viral and bacterial needs to be referred.

Question 7

What is Psoriasis?

Answer 7

chronic inflammatory skin condition affecting 2-3% of population UK.
Occurs commonly in SECOND and SIXTH decade of life
Can be a long life condition.

Question 8

What are the four major clinical types of Psoriasis?

Answer 8

1) chronic plaque psoriasis (most common 80%)
2) Guttate psoriasis - acute form
3) Pustular psoriasis
4) Erythrodermic psoriasis

Question 9

How does chronic plaque psoriasis look?

Answer 9

Well-defined thickened red symmetrical plaques 
Silvery scales
Itching can occur in 50%
scalp involved in 80%
nail involved in 50%

Question 10

What is the aetiology and pathophysiology of chronic plaque psoriasis?

Answer 10

There is a genetic predeposition
Environmental factors also involved
Complex immunnological basis
Epidermal turnover increases
Epidermal thickness increases
Thick keratin scale = silvery scales.

Question 11

What are exacerbating factors of pasoriasis?

Answer 11

Drugs- lithium, ACE inhibitors, ANtimalarials, NSAIDs, Beta blockers
Sunlight (although UV is sometimes used to treat psoriasis
Trauma
Hormonal chnages
Physiological stress

Question 12

What is Guttate Psoriasis?

Answer 12

Acute form of psoriasis that occurs more often in children and young adults
Wide spread small scaly lesions
Commonly follows a streptoccocal throat infection
Will clear after 8 weeks of topical therapy
Can develop into chronic psoriasis.

Question 13

WHat is pustular psoriasis?

Answer 13

Localised: begins eith white pustules, develops into a brown/yeollw pusutles on soles of palm or feet
Generalised: Pustuels develpos on inflammed skin
AN acute onset requires hospital admission

Question 14

What is Eryhtrodermic psoriasis:

Answer 14

REd inflammed skin covering whole body.
Scaling
Skin is hot to touch
Patient has a chill
Precipitated by oral or potent topical steroid withdrawal
REquires hospital admission.

Question 15

WHich two types of psoriasis requires hospital admissions?

Answer 15

acute Pustular psoriasis

Erythrodermic psoriasis.

Question 16

Possible topical treatments NICE guidance on Eczema treatment:

Answer 16

Emollients
Topical corticosteroids
Topical Vit D and analogues
COal Tar - anti scaling properties often used on scalp
Salicylic acid combined with coal tar
Ditranol

Question 17

Possible systemic treatments of psoriasis:

Answer 17

-Methotrexate
Ciclosporin
Oral retinoid
TNF-alpha inhibitors

Question 18

WHat is the other possible treament of psoriasis?

Answer 18

Photochemotherapy

Question 19

Whta is Hyperhidrosis?

Answer 19

Excessive sweating from the eccrine sweat gland

Has a significant impact on quality of life

Question 20

What is the treametn for hyperhidrosis?

Answer 20

There is only limited simple treatment options.
-Alumminium chloride hexhydrate - powder that blocks the sweat duct
other treatments are avaialbele but would need outpatient sappointment,

Question 21

Drug induced rashes:

Answer 21

Nearly all drugs can either cause or exacerbate skin rashes. Frequrently:

• antibiotics
• sulphnamides
• Thiazides
• Barbiturates
• Anticonvulsants
• Salicylates
• Gold