Derm

Question 1

Mx impetigo

Answer 1

1. Flucloxacillin 500mg QID for 7 days

(Trimethoprim + Sulfamethoxazole 160/800mg BD for 3 days - penicillin allergy)

2. Topical Mupirocin 2% TDS for 5 days

Question 2

Seborrheic dermatitis (facial, flexure) - mx

Answer 2

Hydrocortisone 1% + clotrimazole 1% cream

Question 3

Phytophotodermatitis

Answer 3

• phototoxic reaction to contact with certain plants

Question 4

Pompholyx

Answer 4

• itchy vesicles, usually on fingers
• lasts weeks, tends to recur
• may be larger vesicles on palms / soles
• can be precipitated by tinea of the feet

Question 5

Adverse effects of roacutane

Answer 5

• dry lips, eyes, mucosal lining of nose
• early flare of acne
• chelitis
• sun sensitivity
• impaired night vision
• headache
• lethargy

Question 6

Mx guttate psoriasis

Answer 6

• coal tar topical 1% emulsion BD for 1/12
• potent topical corticosteroids - mometasone 0.1% daily for 2/52
• calcipotriol topical daily
• antihistamine for pruritis

Question 7

Erythromelalgia tx (red hot painful extremities)

Answer 7

Aspirin 300mg daily

Question 8

Peri-oral dermatitis mx

Answer 8

Belongs to rosacea spectrum of disease

- Doxy 50-100mg daily 8/52

Question 9

DDx rosacea

Answer 9

1. Seborrhoeic dermatitis
2. Peri-oral dermatitis
3. Acne vulgaris
4. Keratosis pilaris
5. SLE

Question 10

Triggers associated with worsening rosacea

Answer 10

• hot or cold
• wind
• spicy food
• alcohol
• sun exposure
• exercise
• dairy
• certain skin products, makeup, cosmetics

Question 11

Non-pharmacological mx rosacea

Answer 11

• inform patient of chronic, intermittent, inflammatory condition
• identify and avoid triggers
• broad spectrum sunscreen
• moisturiser if skin is dry
• avoid abrasive products
• cosmetics with green tint can camouflage erythema

Question 12

DDx atopic dermatitis (eczema)

Answer 12

• allergic / irritant dermatitis
• seborrhoeic dermatitis
• psoriasis
• scabies

Question 13

Vitiligo mx options

Answer 13

• cosmetic camouflage
• potent topical steroid Diprosone 0.5% cream BD 3/12
• topical pimecrolimus 1% cream BD 3/12
• phototherapy
• do nothing if pt happy to leave alone

Question 14

Erythema multiforme (target lesions)
- 3 possible causes

Answer 14

• idiopathic
• HSV
• medications

Self limiting, can tx with potent topical steroid

Question 15

Drugs that can cause photosensitivity

Answer 15

• oral abx Doxy
• NSAIDs
• roaccutane
• amiodarone
• thiazides

Question 16

Felon

• description
• mx

Answer 16

Closed space infection of distal phalanx pulp, (finger tip), painful and decompression is essential

Needs vertical I&D +/- oral abx