derm

Question 1

Tx erythema nodosum

Answer 1

NSAIDS

Question 2

resp infections associated with what type of vasculitis

Answer 2

Henoch schonlein purpura HSP

Question 3

Ix HSP

Answer 3

AUTOANTIBODIES- ANCA, ANA, RF
Bloods- FBC, renal, CXR- for pulmonary involvement

Question 4

Mx HSP

Answer 4

rest, analgesia
SEVERE cases- corticosteroids/immunosuppressants

Question 5

what skin condition associated with coeliac disease

Answer 5

dermatitis herpetiformis

Question 6

what skin condition is DAPSONE used to treat

Answer 6

dermatitis herpetiformis

Question 7

most common type of skin drug reaction

Answer 7

TOXIC ERYTHEMA

Question 8

NAME the 3 types of erythema multiforme in order of severity

Answer 8

least
Erythema multiforme
-Stevens-Johnson syndrome
-Toxic epidermal necrolysis
MOST

Question 9

what does erythema multiforme look like

Answer 9

target lesions

Question 10

 Prodrome of fever, weakness, respiratory symptoms
 Typical target-shaped lesion
 Red/pink macules > papules > plaques > darkening (purpuric), blistering/crusting
 Lesions may begin on backs of hands/feet > progress proximally
 Always affects mucosal sites - commonly lips/tongue/cheeks, also conjunctivae and others

Answer 10

SJS

Question 11

Toxic epidermal necrolysis:

Answer 11

 Widespread erythema, then significant necrosis + detachment of epidermis (>30% of body area)
 Mucosal, respiratory and GI involvement
 7-21 days initiation
 ~30% mortality
 1000x increased risk in HIV+
 Causes:
o Drugs - penicillin, sulphonamides, NSAIDs, allopurinol, anticonvulsants
 Management:
o Burns unit/ITU
o Withdraw offending drug
o Hydration
o Nutritional support
o Short term dexamethasone, IV immunoglobulin

Question 12

Antibodies against desmoglein 3 are seen in ????

Answer 12

pemphigus vulgaris

Question 13

Pityriasis versicolor is caused by

Answer 13

Malassezia furfur

Question 14

typically affects nose, cheeks and forehead
flushing is often first symptom
telangiectasia are common
later develops into persistent erythema with papules and pustules
rhinophyma
ocular involvement: blepharitis
sunlight may exacerbate symptoms/

Answer 14

acne rosacea

Question 15

keloid scars common in?

Answer 15

young black males

Question 16

keloid treatment

Answer 16

intra-lesional steroids e.g. triamcinolone

Question 17

what medication exacerbates plaque psoriasis

Answer 17

beta blocker propanolol

Question 18

what causes eczema herpeticum

Answer 18

MOST common: HSV1+2
Rarely coxasackie

Question 19

bullous pemphygoid vs pemphigus vulgaris

Answer 19

mucosal involvement in pemphigus VULGARIS

Question 20

renal transplant skin ca risk

Answer 20

SCC

Question 21

scabies management

Answer 21

permethrin 5% is first-line
malathion 0.5% is second-line

normal for pruitus 6-8 weeks after treatment

Question 22

Acne vulgaris in pregnancy treatment

Answer 22

oral erythromycin

Question 23

deficiency of what causes pellagra

Answer 23

niacin deficency- comes from nicotinic acid

Question 24

which mineral and which vitamin deficiency causes angular chelitis?

Answer 24

ZINC
vit b2 riboflavin

Question 25

pityriasis rosea causative organism

Answer 25

Herpes hominis virus 7 (HHV-7)

Question 26

pityriasis versicolor treatment

Answer 26

ketoconazole shampoo (NOT cream)

Question 27

acne rosacea treatment

Answer 27

moderate: topical ivermectin (other- metronidazole) severe: oral doxy and ivermectin

Question 28

bullous pemphygoid treatment

Answer 28

oral corticosteroid OID-- sterOID oral

Question 29

skin ca associated with pUVA therapy

Answer 29

SCC

Question 30

lichen planus first line management

Answer 30

topical steroids

Question 31

Pemphigoid gestationis vs Polymorphic eruption of pregnancy and their treatments

Answer 31

Polymorphic eruption of pregnancy: no blisters Tx= emollients, mild potency topical steroids and oral steroids may be used looks MORE WIDESPREAD and bitty pehmphygoid gestationis; blistering, peri umbilical Tx= oral corticosteroids are usually required

Question 32

which psych med worsens psoriasis

Answer 32

lithium

Question 33

photosensitive rash with blistering and skin fragility on the face and dorsal aspect of hands hypertrichosis hyperpigmentation

Answer 33

Porphyria cutanea tarda

Question 34

Ix Porphyria cutanea tarda

Answer 34

urine: elevated uroporphyrinogen and pink fluorescence of urine under Wood's lamp serum iron ferritin level is used to guide therapy

Question 35

management porphyria cutanea tarda

Answer 35

chloroquine venesection

Question 36

dermatitis artefacta

Answer 36

Linear, well-demarcated skin lesions that appear suddenly, with 'la belle indifference' pts doing it them self- self harm

Question 37

wood-grain' pattern and figurate erythema commonly seen in patients with lung cancer

Answer 37

Erythema gyratum repens

Question 38

meds causing erythema nodosum

Answer 38

COCP sulphonamides penicillins

Question 39

treatment MRSA impetigo golden crust what orgs cause impetigo

Answer 39

1. fusidic acid 2. mupirocin caused by staph aureus or strep pyogenes

Question 40

fir tree appearance

Answer 40

fir tree Pityriasis rosea

Question 41

Porphyria cutanea tarda cause CFs Ix Tx

Answer 41

most common hepatic porphyria. It is due to an inherited defect in uroporphyrinogen decarboxylase or caused by hepatocyte damage e.g. alcohol, hepatitis C, oestrogen. CFs photosensitive rash with blistering and skin fragility on the face and dorsal aspect of hands hypertrichosis hyperpigmentation Investigations urine: elevated uroporphyrinogen and pink fluorescence of urine under Wood's lamp serum iron ferritin level is used to guide therapy Management chloroquine venesection preferred if iron ferritin is above 600 ng/ml

Question 42

topical steroid strength

Answer 42

Topical steroids moderate: Clobetasone butyrate 0.05% potent: Betamethasone valerate 0.1% very potent: Clobetasol propionate 0.05%

Question 43

systemic mastocytosis CFs diagnosis

Answer 43

Features urticaria pigmentosa - produces a wheal on rubbing (Darier's sign) flushing abdominal pain monocytosis on the blood film Diagnosis raised serum tryptase levels urinary histamine

Question 44

which viruses )numbers) cause eczema herpeticum

Answer 44

HSV 1 AND 2

Question 45

dermophyte nail fungal infection treatment

Answer 45

PO terbinafine 12 weeks

Question 46

irritant contact dermatitis VS allergic contact dermatitis:

Answer 46

allergic contact dermatitis: common not allergy caused by hair dyes allergic contact dermatitis: type 4 hypersensitivity reaction more uncommon

Question 47

causative drugs SJS

Answer 47

COCP sulphonamides- co trimoxazole penicillin lamotrigine, carbamazepine allopurinol NSAIDs

Question 48

caused by IgA deposition in the dermis

Answer 48

dermatitis herpetiformis

Question 49

'wood-grain' pattern, lung ca

Answer 49

Erythema gyratum repens

Question 50

Dermatitis in acral, peri-orificial and perianal distribution-- deficiency of what??

Answer 50

ZINC

Question 51

which antibiotic can cause irreversible skin hypopigmentation

Answer 51

minocycline

Question 52

bullous pemphygoid antibodies vs pemphigus vulgaris

Answer 52

Hemidesmosomal BP antigens pemphigus vulgaris = desmoelgein 3

Question 53

Severe vit a toxicity caused by retinoids in psoriasis cfs

Answer 53

bilateral pappiloedema

Question 54

pemphigus vulgaris treatment levels

Answer 54

1. prednisolone if no response- immunosuppresion with RITUXIMAB