DERM

Question 1

shingles mx

Answer 1

Infectious until vesicles have healed over
Simple analgesia
Antivirals within 72hr

Question 2

Features of stevens johnson syndrome

Answer 2

.the rash is typically maculopapular with target lesions being characteristic

may develop into vesicles or bullae

Nikolsky signis positive in erythematous areas - blisters and erosions appear when the skin is rubbed gently

mucosal involvement

systemic symptoms: fever, arthralgia

Question 3

Medicines causing erythema nodosum

Answer 3

penicillins

sulphonamides

combined oral contraceptive pill

Question 4

Causes of spider naevi

Answer 4

liver disease

pregnancy

combined oral contraceptive pill

Question 5

Features of lichen planus vs sclerosis

Answer 5

planus:purple,pruritic,papular,polygonal rash on flexor surfaces. Wickham’s striae over surface. Oral involvement common

sclerosus: itchy white spots typically seen on the vulva of elderly women

Question 6

Erythema nodosum f eatveres

Answer 6

symmetrical, erythematous, tender, nodules which heal without scarring

most common causes are streptococcal infections, sarcoidosis, inflammatory bowel disease and drugs (penicillins, sulphonamides, oral contraceptive pill)

Question 7

Necrobiosis lipoidica diabeticorum features

Answer 7

shiny, painless areas of yellow/red skin typically on the shin of diabetics

often associated with telangiectasia

Question 8

What is Bullous
Pemphigoid?

Answer 8

autoimmune condition causing sub-epidermal blistering of the skin. This is secondary to the development of antibodies against hemidesmosomal proteins BP180 and BP230.

Question 9

How does Bullous
Pemphigaid
present?

Answer 9

itchy, tense blisters typically around flexures

the blisters usually heal without scarring

no mucosal
involvement

Question 10

Bullous
Pempligoid
skin biopsy
shows?

Answer 10

immunoflorescence lst D C3 at dernmo epidermal
juncker

Question 11

Bulloas
pemphigord
rex?

Answer 11

Steroids
derm ref

Question 12

Rosacea
mx

Answer 12

Erythema/flushing → topical brimonidine gel
Mild/mod papules or pustules: topical ivermectin
Mod/severe papules/pustules: topical ivermectin and oral doxy
Laser therapy for rhinophyma or prominent telangdctasia

Question 13

Chronic plaque psoriasis mx

Answer 13

1. top steroid and calcipotriol
2. top calcipotriol BD
3. Steroid BD

Question 14

Acne Mx

Answer 14

1. topical combo
2. topical tX and oral ly mecycline or doxy
   3.oral retinoid
   C hasto be
   derm)

Question 15

Erythema nodosum features

Answer 15

inflammation of subcutaneous fat
typically causes tender, erythematous, nodular lesions
usually occurs over shins, may also occur elsewhere (e.g. forearms, thighs)
usually resolves within 6 weeks
lesions heal without scarring

Question 16

Causes if erythema nodosum

Answer 16

infection
streptococci
tuberculosis
brucellosis
systemic disease
sarcoidosis
inflammatory bowel disease
Behcet’s
malignancy/lymphoma
drugs
penicillins
sulphonamides
combined oral contraceptive pill
pregnancy

Question 17

Chronic plaque psoriasis secondary care mx option of choice

Answer 17

Oral methotrexate is first line,maprticuarky if associated joint disease

UVB light 3x weekly

Question 18

Scalp psoriasis management

Answer 18

potent topical corticosteroids used once daily for 4 weeks

Question 19

Face flexural and genital psoriasis mx

Answer 19

mild or moderate potency corticosteroid applied once or twice daily for a maximum of 2 weeks

Question 20

Eczema herpetivum

Answer 20

severe primary infection of the skin by herpes simplex virus 1 or 2.
more commonly seen in children with atopic eczema
monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1–3 mm in diameter are typically seen.

As it is potentially life-threatening children should be admitted for IV aciclovir.

Question 21

What is vitaligo

Answer 21

autoimmune condition which results in the loss of melanocytes and consequent depigmentation of the skin. It is thought to affect around 1% of the population and symptoms typically develop by the age of 20-30 years.

Associated conditions
type 1 diabetes mellitus
Addison’s disease
autoimmune thyroid disorders
pernicious anaemia
alopecia areata

Question 22

Management of vitaligo

Answer 22

sunblock for affected areas of skin
camouflage make-up
topical corticosteroids may reverse the changes if applied early
there may also be a role for topical tacrolimus and phototherapy, although caution needs to be exercised with light-skinned patients

Question 23

What is ballous pamphgoid

Answer 23

Or to immune blistering disorder that primarily affects the elderly
Tense blisters on the skin.
No mucosal involvement.

Question 24

whatis pemphigus vulgaris

Answer 24

mucosal involvement
blisters and erosions involving both the skin and mucous membranes

Question 25

EpidermoIysis Bullosa

Answer 25

fragility and blister formation in response to minor trauma
at birth or during early childhood,

Question 26

Actinic keratosis vs bowens

Answer 26

Actinic keratoses may develop on any sun-exposed area, not just the forehead and temple. Bowen’s disease tends to be isolated and well demarcated.

Question 27

Exacerbating factors for psoriasis

Answer 27

trauma
alcohol
drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
withdrawal of systemic steroids