Derm

Question 1

What are the ABCDE signs of melanoma?

Answer 1

ABCDE

Assymetry 
Border (irregular) 
Colour (+1) 
Diameter = bigger 
Evolving changes

Question 2

Name 3 malignant skin conditions

Answer 2

• Melanoma
• Basal Cell Carcinoma
• Squamous Cell Carcinoma

Question 3

What is molluscum contagiosium?

Answer 3

• Viral
• Children
• Skin to skin contact
• Pearly, smooth papules with a central umbilication - face and groin
• Children - Avoid sharing towels / clothing
• Adults - cut the lesions out / freeze them out

Question 4

What is scabies?

Answer 4

• Mites
• Skin to skin
• Overcrowded living conditions
• Treat the whole family, wash clothes > 60
• Topical permethrin + antihistamines

Question 5

What is Steven Johnson syndrome / TEN

Answer 5

• TEN = Toxic epidermal necrolysis
• Fever, skin tenderness, rash
• Severe drug reaction
• High fever, skin tenderness, mucosal erosion, skin detachment
• High mortality for TEN
• Tx: supportive care, stop causative drug (allopurinol, NSAID’s, Abx, anticonvulsants)

Question 6

What are the common causative drugs of SJS / TEN?

Answer 6

• NSAID’s
• Allopurinol
• Anticonvulsants

Question 7

Difference between SJS and TEN?

Answer 7

% of skin coverage

• TEN = more common in the old
• SJS = more common in children

Question 8

What is erythema nodosum?

Answer 8

• Tender, bilateral, subcutaneous nodules
• Hypersensitivity reaction
• Fever and joint pain
• Associated with drugs (amoxillcin, COCP), infection (chlamydia, TB), inflammatory condition (IBD, sarcoidosis), malignancy

Question 9

List some differentials for itch that are NOT primary skin disorders

Answer 9

• Renal (urea mediated)
• Cholestatic (bile salts)
• Haematological (increased number of basophils and mast cells in the skin)
• Endocrine
• Malignant (hodgkin lymphoma, carcinoid)
• Drugs (morphine)

Antihistamines - promethasine (good for sleep too)

Question 10

What causes chicken pox?

Answer 10

Varicella Zoster

Question 11

Which people will prompt you to worry about a diagnosis of chicken pox and why?

How will you treat these individuals?

Answer 11

• Pregnancy (neonatal chicken pox = 30% mortality) immunocompromised, young and old
• Can cause severe disease
• Acyclovir / IV immunoglobulins

Question 12

What is the difference between shingles and chickenpox?

Answer 12

Chicken pox = Varicella Zoster

Shingles, also known as herpes zoster = varicella zoster that lies DORMANT in the nerve route ganglion - can reactive many years after the individual has had shingles

Question 13

What is the general treatment for chicken pox?

Answer 13

• Usually self-limiting
• Paracetamol = fever
• Antihistamines - deal with the itch

Question 14

What are typically the worst affected areas in acne?

Answer 14

• Upper back
• Face
• Chest

Question 15

How is acne treated?

Answer 15

Topical = salicyclic acid / benzoyl peroxide

Systemic (women) = COCP, spironolcatone

Antibiotics (anti-inflammatory effects)

Isoretinoin - moderate to severe

Question 16

Which acne treatments should be avoided in pregnant women?

Answer 16

• Retinoids - TERATOGENIC