Derm

Question 1

Risk factors for SCC

Answer 1

• Excess sun/psoralen UVA
• Actinic keratoses + Bowen’s disease
• Immunosuppression
• Smoking
• Chronic leg ulcer
• Xeroderma pigmentosum, oculocutaneous albinism

Question 2

Seborrhoeic dermatitis - associated underlying conditions

Answer 2

HIV

Parkinsons

Question 3

Seborrhoiec dermatitis - management of scalp disease - 1st line

Answer 3

OTC preparations containing zinc pyrithione or tar

Question 4

Seborrhoiec dermatitis - management of scalp disease - 2nd line

Answer 4

Ketoconazole

Question 5

Seborrhoiec dermatitis - face + body management

Answer 5

Topical antifungals: ketoconazole

Topical steroids for short periods

Question 6

Erythematous facial rash sparing the nasolabial folds

Answer 6

Acne rosacea

Question 7

Erythematous facial rash involving the nasolabial folds

Answer 7

Seborrhoeic dermatitis

Question 8

Antibodies present in bullous pemphigoid

Answer 8

Anti-hemidesmosomes

Question 9

Skin biopsy immunofluorescence - shows IgG and C3 at dermoepidermal junction

Answer 9

Bullous pemphigoid

Question 10

Features of BCC (“rodent ulcer”)

Answer 10

Initially - Pearly, flesh-coloured papule, telangiectasia

Later - ulceration + central crater

Question 11

Features of Bowen’s disease

Answer 11

Red, scaly patches
Slow-growing
Sun-exposed areas

Question 12

Features of pyogenic granuloma (“eruptive haemangioma”)

Answer 12

RAPID growth
from small red/brown SPOT,
to raised red/brown spherical lesion
within days/weeks

Question 13

Diagnostic test for pemphigus vulgaris

Answer 13

Direct immunofluorescence of skin

Question 14

Features of granuloma annulare

Answer 14

Smooth annular flesh-coloured lesion.

No scale

Question 15

Features of tinea corporis

Answer 15

Annular erythematous plaque, with raised edge and scale

Question 16

Management of granuloma annulare

Answer 16

Await resolution

Topical steroids if itch/cosmetic concern

Question 17

Management of tinea corporis

Answer 17

Oral fluconazole

Question 18

Management of vitiligo

Answer 18

Oral steroids and azathioprine

Question 19

Vitiligo vs pityriasis versicolor

Answer 19

Vitiligo likely to be associated with other auto-immune diseases

Question 20

Features of dermatofibroma (histiocytoma)

Answer 20

Benign fibrous skin lesion

Pinch test > forms a dimple

Question 21

Features of BCC

Answer 21

Sun-exposed - head & neck
Pearly papule
Prominent telangiectasia
Later ulcerates > crater

Question 22

BCC - commonest treatment

Answer 22

Surgery

Question 23

Features of keratoacanthoma

Answer 23

Dome shaped
Symmetrical
Keratotic/necrotic core
Rapid growth (months)

Question 24

Treatment of keratoacanthoma

Answer 24

Urgent excision to exclude SCC

Question 25

Features of SCC

Answer 25

Initially scaly erythematous patch

Question 26

Treatment of SCC

Answer 26

Surgical excision

Question 27

Treatment of metastatic melanoma

Answer 27

Pembrolizumab (PD-1 receptor blocker)

Question 28

Features of actinic keratoses

Answer 28

Erythematous plaques

Sun-exposed area

Question 29

Treatment of actinic keratoses

Answer 29

Topical 5-FU/diclofenac/salicyclic acid