Derm 1

Question 1

Painful lumps/nodules on the shin with bilateral hilar lymphadenopathy → Ddx?

Answer 1

Sarcoidosis or TB

erythema nodosum alone → sarcoidosis, TB, streptococcal infection, IBD

Question 2

What are these?

heliotrope rash on the eyes

on knuckles = Gottron’s papules

photodistributive disruption

Answer 2

dermatomyositis = AID

mx = immune suppression

MUST look for underlying malignancy as a paraneoplastic feature of malignancy

Question 3

What are these?

Answer 3

Acne, psoriasis and eczema (going clockwise)

Question 4

Ix and mx of Derm

Answer 4

laser

pathology

patch testing

dermatoscopye

cryotherapy

biopsy

Question 4

Ix and mx of Derm

Answer 4

laser

pathology

patch testing

dermatoscopye

cryotherapy

biopsy

Question 5

What is this?

Answer 5

onycholysis = pitting edge come off nail bed, yellow discolouration

Alopecia areata = circles of hair loss, complete hair loss, white regrowth

PSORIASIS

Question 6

Answer 6

Macule

Question 7

Answer 7

vesicle

recurrent HSV

Question 8

honey-coloured

Answer 8

Honey-coloured crust and slightly wet

IMPETIGO = caused by staph aureus (a lot in the nose)

Question 9

lump less than .5 cm

Answer 9

papule

BASAL CELL CARCINOMA = not life-threatening as does not metastasise but can cause problems especially if near eye as local damage

pearly rolled-edge, telengiactasia

Question 10

bigger than .5 cm

Answer 10

Patch

Cafe-au-lait patch

IF MORE THAN 5 → NEUROFIBROMATOSIS

Question 11

Answer 11

Plaque = salmon coloured

Psoriasis

joint-pain/arthritis, onycholysis, alopecia

Question 12

Answer 12

Ulcer

pyoderma gangrenosusm = IBD, rheumatoid arthritis, haematological malignancy (e.g. myeloma)

Question 13

Answer 13

SCABIES = sudden onset itchy rash, other people around infected

burrow

Question 14

Answer 14

Nodular cystic acne

Question 15

Answer 15

Bullous pemphigoid

Question 16

Answer 16

Pustule

Staph aureus cutaneous infection

diabetes can predispose you to frequency cutaneous infection

Question 17

Scaly on arm, multiple red scaly eruptions

put steroids (worked initially but then got bad)

Answer 17

ringworm, cutaneous dermatophyte infection, tinea corporis

STEROIDS DON’T WORK (steroids are immunosuppressive, so don’t help any infections)

Question 18

Answer 18

Pitoriasis Rosea = Christmas tree distribution

response to viral infection (e.g. HSV)

Question 19

Answer 19

pityriasis vesicolor or vitiligo (ask what is your normal skin)

caused by fungus

ix = skin scraping (spaghetti and meatballs)

Question 20

photo damage on skin

Answer 20

actinic keratoses

up to 10% can become squamous cell carcinoma (cancers of keratinocytes)

Question 21

flaky eyebrows, red face, dandruff in scalp, red rash on arms and legs

Answer 21

seborrhoeic dermatitis

discoid eczema

yeast infection (same yeast that causes pityriasis vesiculor)

scratchy → local staph can get inside and cause impetigo

check for underlying HIV infection

Question 22

well defined erythematous rash

wrinkling = atrophy on skin

scaling

Answer 22

mycoses fungoides, cutaneous T cell lymphoma

patch stage → plaque stage → tumour stage (Nodular)

Question 23

chest infection, given abx, rash developed, in trunks and upper arms, maculapapular appearance

Answer 23

drug rash

toxic epidermal necrolysis can happen next

tx = stop drug, supportive treatment with topical steroids and emollients