Benign rashes

Question 1

PITYRIASIS ROSEA
i) what is it? who is it most common in?
ii) what characteristic feature is seen at the start? how does this look? what size is it?
iii) name three characteristics of the rash? how may lesions be arranged
iv) name three other symptoms thaat may be present

Answer 1

i) generalised self limiting rash with unknown cause (could be herpes virus)
most common in teenagers and young adults
ii) herald patch appears on torso - faint red or pink, scaly oval lesion that is >2cm in diameter
iii) faint red, pink, scaly, oval less than 2cm diameter
may be arranged in christmas tree fashion following lines of the ribs
iv) generalised itch, low grade fever, headache, lethargy

Question 2

PITYRIASIS ROSEA MX
i) how long does it usually take to resolve?
ii) what is the mainstay of treatment? is it contagious?

Answer 2

i) usually self resolves in 3 months
ii) no treatment will resolve alone - patient education and reassurance - not contagious
tx may be required if itchy - emollient, steroids

Question 3

SEBORRHOIEC DERMATITIS
i) what is it? what area does it. affect? (3)
ii) how does it manifest? what is usually seen in infants?
iii) which organism can cause it? what tx usually improves it

Answer 3

i) inflammatory skin conditions affecting the sebaceous glands - affects scalp, nasolabial folds, eyebrows
ii) causes erythema, crusted dry skin
infants - crusty dry flaky scalp (cradle cap)
iii) malassezia yeast can cause it
tx with anti fungals

Question 4

INFANT SEB DERM
i) what is the main feature seen? when does it usually resolve by?
ii) what is first line tx? what can be used if this is not effective
iii) what may be used for up to 4 weeks? what can be done if this does not work

Answer 4

i) crusted flaky scalp - self limiting and usually resolves by 4 months of age
ii) first line - baby oil, olive oil, brush scalp then wash it off
if not effective - use white petroleum jelly overnight and wash in the morning
iii) anti fungal cream eg clotimazole or miconazole

Question 5

SEB DERM OF OTHER BODY PARTS
i) how does SD of the scalp it present? what is a more severe presentation? what is first line tx? what can be given if severe itching
ii) how does SD of face and body present? name four areas it commonly affects
iii) what is first line tx of SD of face and body? how long is this used for? what can localised inflamed areas be treated with?

Answer 5

i) mild scalp - flaky itchy skin
more severe - dense oily scaly brown crusting
first line tx is ketoconazole shampoo - leave for 5 mins and wash off
can use topical steroid if severe itching
ii) face and body - red flaky crysted itchy skin
commonly aff eyelids, nasolabial folds, ears, upper chest and back
iii) first line tx for face and body is anti fungal cream eg clotrimazole or miconazole
localised inflam - topical steroid eg hydrocortisone 1%

Question 6

GUTTATE PSORIASIS
i) what is it classically preceeded by?
ii) how does it appear?
iii) how long does it take for post cases to resolve? what treatment may be given

Answer 6

i) classically preceeded by a strep sore throat 2-4 weeks ago
ii) tear drop scaly papules on trunk and limbs
iii) usually resolves in 2-3 months
can be given topical tx as for psoriasis or UVB phototherapy

Question 7

LICHEN SCLEROSIS
i) what is it? who does it most commonly affect?
ii) what does it lead to on the skin?
iii) name two features? when may pain be felt?
iv) what type of diagnosis is made? what can be given to manage
v) what type of cancer is there increased risk of

Answer 7

i) inflammatory condition that affects the genitalia and is more common in elderly women
ii) white patches that may scar, itchy skin - pain during intercourse and urination
iv) clinical dx - give topical steriods and emollients
v) increased risk of vulval cancer