Derm bits and pieces

Question 1

Which features are NOT found in acne rosacea?

Answer 1

Comedones

Question 2

What are the features of acne rosacea?

Answer 2

Blushing and flushing (this condition is proangiogenic)
Enlarged sebacous glands and soft tissue
Papules
Pustules

Question 3

What can trigger acne rosacea?

Answer 3

Prolonged use of steroids

Question 4

What is the first line treatment for acne rosacea?

Answer 4

Topical metronidazole

Question 5

How can the blushing aspect of acne rosacea be managed?

Answer 5

Cosmetic concealers, vascular laser surgery

Question 6

What is the second line treatment for acne rosacea?

Answer 6

Topical metronidazole plus oral tetracycline

Question 7

What are the complications of acne rosacea?

Answer 7

Blepharitis and keratitis - ocular involvement

Question 8

Why are creams are more likely than ointments to cause contact sensitisation?

Answer 8

Because they contain preservatives

Question 9

What type of inheritance pattern does neurofibromatosis have?

Answer 9

autosomal dominant

Question 10

What type of inheritance pattern does tuberous sclerosis have?

Answer 10

autosomal dominant

Question 11

What is the aetiology of pemphigus vulgaris?

Answer 11

RARE autoimmune condition

Usually presents in mid-adult life

Question 12

What is the aetiology of bullous pemphigoid?

Answer 12

Commoner than pemphigus vulgaris

Usually people >60yrs old get it

Question 13

In pemphigus vulgaris which structure do auto antibodies target?

Answer 13

Desmosomal proteins

Question 14

In BULLOUS pemphioig which structure do auto antibodies target?

Answer 14

Hemidesmosomal proteins

Question 15

What are the clinical features of pemphigus vulgaris?

Answer 15

• INTRAEPIDERMAL blisters that are FRAGILE, FLACCID and non itchy
• Blisters will rupture easily and leave weeping erosions
• Oral ulcers (mucosal involvement)

Question 16

What are the clinical features of bullous pemphigoid?

Answer 16

• LARGE, TENSE bullae (blisters)
• can be very itchy
• Inflamed and itchy underlying skin (resembles urticaria in early disease)

Question 17

What is the main histological feature of pemphigus vulgaris?

Answer 17

Loss of keratocyte adhesion, sometimes seperation of the stratum corneum from the rest of the epidermis.

Question 18

What are the histological features of bullous pemphigoid?

Answer 18

Sub-epidermal split through the basement membrane

IgG and complement deposition at the dermo-epidermal junction

Question 19

How are blistering disorders managed?

Answer 19

Steroids usually, but steroid-sparing immunosuppressive agents such as azathioprine are used in severe cases.

Question 20

Where are venous ulcers usually found?

Answer 20

Medial or lateral malleoulus

Question 21

Where are arterial ulcers usually found?

Answer 21

On the foot or mid shin

Question 22

What does breslow thickness mean?

Answer 22

depth from the GRANULAR LAYER of the epidermis to the deepest melanoma cell. Used as a measure of prognosis for nodular and superficial malignant melanoma.

Question 23

Which skin cancer is most deadly?

Answer 23

Malignant melanoma, then squamous cell carcinoma then basal cell carcinoma.

Question 24

Which skin cancer is most common?

Answer 24

Basal cell carcinoma

Question 25

Which skin cancer grows slowly?

Answer 25

Basal cell carcinoma

Question 26

Which skin cancers grow fast?

Answer 26

Squamous cell carcinoma and Malignant melanoma

Question 27

What are the two conditions that SCC can arise from?

Answer 27

Bowen’s disease

SOLAR/actinic keratoses

Question 28

Where does SCC commonly arise?

Answer 28

On the helix of the ear

Question 29

What are the features of dermatofibroma?

Answer 29

Pink beige firm nodules, surrounded by a ring of hyperpigmentation.

Question 30

how does solar/actinic keratoses present

Answer 30

rough scaly patches on sun exposed areeas

Question 31

What are the features of dermatitis herpetiformis?

Answer 31

• Papules and vesicles
• itchy
• IgA deposits
• associated with coeliac disease