Derm

Question 1

Naevi
What do congenital naevi look like?
How large can they get?
What are the two main risks do they carry? 
When and what ix should they have?

Answer 1

Flat and dark in colour
Giant= >20cms 
CNS and spine lesions
Melanoma 
MRI brain by 6m

Question 2

What is the difference between junctional, intradermal and compound naevi?

Answer 2

Junctional-flat
Intradermal- raises with a hair
Compound- a mix of both

Question 3

Structure of the skin

What are the three main layers

Answer 3

Epidermis
Dermis
Subcutaneous layer

Question 4

Which skin layer has further subdivisions?

What are they

Answer 4

Epidermis- keratinocytes

Corneum, lucidum, granulosum, spinousum, basale
Corn lovers grow straw bales

Question 5

Neonatal rashes
When does erythema toxicum present
Where does it spare
If you did an investigation what would it be and what would it show?

Answer 5

First 24-48 hrs
Spares palms and soles
Wright staining- eosinophils

Question 6

Neonatal rashes

How do transient neonatal pustular Melanosis differ to erythema toxicum

Answer 6

Transient- no erythema below. More common in darker skins. Neuts only in stain. Can cause hypopigmentation post

Question 7

Neonates
How does cephallic pustulosis present
What is seen on smear

Answer 7

Like acne

Eosinophils and yeast

Question 8

Neonatal rashes
What causes milaria crystallina
How do they resolve
What form has erythema

Answer 8

Blocked sweat glands
With cooling
Miliaria rubra

Question 9

Neonatal rashes
How does acropustulosis of infency present?
What might it be secondary to?
What is seen on stain

Answer 9

Crops of itchy pustules usually on the hands and feet
Post scabies!
Neutrophils

Question 10

Genetics and derm
What is the most common gene defect in eczema
How is it inherited?

Answer 10

Fillagrin

Autosomal dominant

Question 11

What are the three features of nethertin syndrome
What gene is involved
What is the inheritance

Answer 11

Scaly dry skin (itchyosis linearis)
Atopy
Bamboo hair

SPINK 5 gene
Autosomal recessive

Question 12

Hyper igE syndrome
What is the genetic defect
What is the inheritance
How does it present

Answer 12

Stat 3
Autosomal dominant
Eczema, coarse face, recurrent infection with encapsulated organisms, retained teeth

Question 13

X linked itchiosis
What is the gene defect
What are the features

Answer 13

Steroid sulphatase deficient
X linked recessive
Eczema, cryptorchidism and corneal opacities

Question 14

What is the difference between SJS and TEN
How do they present

What hla associations- carbamazepine, allopurinol

How soon after the drug is given does it happen

Answer 14

SJS<10%, ten>30%
Urti, painful skin, erythema. Blisters that slough off and crust over

Hla b 1502
Hla b 5801

7-21 days

Question 15

What are the two biggest causes of erythema multiforme

What is erythema multiforme major

Answer 15

HSV, mycoplasma

Mucosal involvement

Question 16

What is an example of a morbilliform drug eruption

Answer 16

EBV and amoxicillin

Question 17

What does a fixed drug eruption look like

How soon after meds do they occur

Answer 17

Brown or purple plaque, at the same place each time

3-8 hrs

Question 18

What is DRESS
How soon after drug admin does it occur
Other than stopping the drug, how can it be treated

Answer 18

Drug eruption with eosinophilia and systemic symptoms
More than three weeks
Steroids

Question 19

What is the most common cause of serum sickness like reactions in children
Do they have immune complex deposition

Answer 19

Cefaclor

No! (Serum sickness LIKE)

Question 20

What normally triggers urticaria multiforme

Answer 20

A virus

Question 21

What is the key feature of the rash in hereditary angiodema

What are the most specific investigations
What is low during an attack

Answer 21

No wheals but angiodema

C4 level and c1 inhibitor level
C4 level

Question 22

Itchyosis
What is the mildest form called
What is the lethal cause
What will a baby be born like in CIE or lamellar forms

Answer 22

Vulgaris
Harlequin
Colloidian body- like in a sausage

Question 23

What is the risk of atopy

• 1 first degree relative has it
• 2 have it

Answer 23

50%

75%

Question 24

What new MAB might be useful for eczema

Answer 24

Dupilumab- IL 4/5

Question 25

Other than platelets what else can be affected by a massive haemangioma

Answer 25

Thyroid- hypo

Question 27

Incontinenti pigmenti
What are the 4 stages
What is the gene
What are their teeth like

Answer 27

Vesicular verrucous hyper then hypopig
NEMO
Shark teeth!