derm

Question 1

herald patch == beginning of ?

+ management

Answer 1

pityriasis rosea

conservative mx, self limiting

Question 2

pregnancy + blisterin + involves umbilicus = ?

Answer 2

Pemphigoid gestationis

Question 3

pregnancy rash sparing umbiicus

Answer 3

Polymorphic eruption of pregnancy

starts in striae

Question 4

alopecia areata mx

Answer 4

Topical corticosteroid + referral to dermatologist
topical or intralesional corticosteroids
topical minoxidil
phototherapy
dithranol

Question 5

Eczema herpeticum mx

Answer 5

life threatening for kids
admit for IV Aciclovir

Question 6

psoriasis mx

Answer 6

1. potent corticosteroid applied once daily plus vitamin D analogue applied once daily for 8 weeks max

2.second-line: if no improvement after 8 weeks then offer:
a vitamin D analogue twice daily

3. third-line: if no improvement after 8-12 weeks then offer either:
   a potent corticosteroid applied twice daily for up to 4 weeks, or
   a coal tar preparation applied once or twice daily
   short-acting dithranol can also be used

DERM SECONDARY CARE REFER

Question 7

psoriasis mx when referred to derm

Answer 7

Phototherapy
narrowband ultraviolet B light is now the treatment of choice. If possible this should be given 3 times a week

Systemic therapy
oral methotrexate is used first-line. It is particularly useful if there is associated joint disease
ciclosporin
systemic retinoids
biological agents: infliximab, etanercept and adalimumab
ustekinumab (IL-12 and IL-23 blocker) is showing promise in early trials

Question 8

pityriasis versicolor caused by?

Answer 8

Malassezia yeast
The condition can often present after spending time in sunny, humid environments. It is treated with topical antifungals eg. ketoconazole shampoo.

Question 9

keloid mx

Answer 9

refer for intralesional triamcinolone

Question 10

impetigo

Answer 10

golden crust
mx = topical fusidic acid

Question 11

rolled pearly edges+telangiectasia

Answer 11

bcc

Question 12

benign, painful nodule on the ear, well-demarcated and very tender to palpation + scale

Answer 12

Chondrodermatitis nodularis

Question 13

SJS CFs

Answer 13

skin + mucosa
<10%
sulphonamides
lamotrigine, carbamazepine, phenytoin
allopurinol
NSAIDs
oral contraceptive pill

Question 14

spider naevi causes

Answer 14

cocp
preganncy
liver disease

Question 15

trpe of skin ca for immunosuppressed pts

Answer 15

SCC

Question 16

tchy, polygonal, violaceous papules on the flexor aspect of his forearms.

Answer 16

lichen planus

pPppppPpppppps

Question 17

leg rash on middle aged women with diabetes
bilateral, well-demarcated erythematous plaques on the shins which are often surrounded by telangiectasia and may have a yellowish hue due to lipid deposition

Answer 17

Necrobiosis lipoidica

Question 18

tx lichen planus

Answer 18

topical clobetasoe

Question 19

coeliac diseas common skin condition

Answer 19

Dermatitis herpetiformis

Question 20

bullous pemphigoid vs pemphigus vulgaris

Answer 20

no mucosal involvement: bullous pemphigoid
mucosal involvement: pemphigus vulgaris

PemphigUS = mucUS
PemphigOID = avOID