DERM ICM

Question 1

What is Mycology?

Answer 1

the study of fugus organisms causing disease in human

Question 2

What is are Nail clippings used for?

Answer 2

• confirm fungal nail infections

- differentiate nail infections from dystrophic nails

Question 3

What can you do with nail clippings?

Answer 3

MCS

~ takes around 4-5days to culture and get results

Question 4

What is Skin scaping?

Answer 4

a superficial scraping of the skin is taken from the rash/affected area of concern

Question 5

Skin scraping indications?

Answer 5

• used mainly to diagnose fungal skin infections

- skin rash/lesion unresponsive to treatment to confirm dx

Question 6

What can be done with skin scrapings?

Answer 6

MCS

~4-5days for results to be obtained from lab

Question 7

Skin Biopsy indications?

Answer 7

• removal of confirmed/suspected skin cancer
• unknown skin lesions/growths
• skin tags
• warts

Question 8

What are the types of skin biopsies?

Answer 8

shave biopsy - scalpel/blade used to take a shaving
punch biopsy - circular tool takes a core sample
excisional biopsy - wider skin excisions include the tissue around the margins of lesion

Question 9

What is Wood’s Lamp? How does is work?

Answer 9

Another form of mycology
handhled devise emitting long waves of UV light
normal skin - not fluorescent
abnormal skin - fluorescent

Question 10

What is Wood’s Lamp used for?

Answer 10

diagnosis of

• fungal skin infections
• bacterial skin infections
• vitiligo
• head lice
• other pigmented lesion

can also be used a confirmation/strengthen a suspicion

Question 11

What is dermascopy? Uses include?

Answer 11

lightweight microscope - allows visualisation of substance patterns/pigmentations and structures of skin

normally used for lesions with red flags - confirming whether or not it is a skin cancer

Question 12

What is Tetradermatology?

Answer 12

offered only in certain boroughs

involves taking photos with a dermascope and sending to dermatology who then provide advice on the suspected diagnosis and management in 2wks

Question 13

What is mole mapping?

Answer 13

body photography using a dermascope for individuals at high risk of developing malignant melanoma or have a hx of previous removed melanoma/atypical naevi

Question 14

What does mole mapping involve?

Answer 14

often pts will have to have been through the 2WWR pathway and need monitoring

otherwise some may go privately

Question 15

Indications for allergy testing?

Answer 15

Previous symptoms of anaphylaxis

food and drug allergy

urticaria/angioedema

asthma

allergic rhinitis

eczema /dermatitis

Question 16

types of allergy testing?

Answer 16

1. skin prick test
2. skin patch
3. RAST/immunochop (blood test)
4. food challenge

Question 17

What does skin prick test involve?

Answer 17

performed in hospital/clinic setting - rare risk of anaphylaxis

allergens are applied to skin - pricked with lancet and wait 10-15mins - assess reaction

• compare against positive control (histamine) and negative control (saline)
• can give results on the same day and provide appropriate advice

Question 18

What does the skin patch test involve?

Answer 18

Used for more delayed reactions such as contact dermatitis

• 3 appts
  1. go and have allergen discs applied - they will be held by hypoallergenic tape
  2. 2/7 - discs removed and recations assessed
  3. 4/7 - assess for any delayed reactions

Question 19

What does the RAST/Immunochop involve?

Answer 19

blood test measuring IgE antibodies to an allergen

- helps to confirm if reaction is false positive if unexpected positive reaction is found on skin prick

Question 20

What are slight downsides to RAST/Immunochop?

Answer 20

info equivalent to skin prick but more expensive to do

results are not same day

less acceptable for children

Question 21

What does Food challenge involve?

Answer 21

Performed in hospital setting - tests for delayed reaction

used to confirm allergy vs sensitisation after skin prick/blood test

Question 22

KOH Test?

Answer 22

A skin lesion KOH exam is a simple skin test to check if an infection in the skin is caused by fungus.
used commonly in dermatophyte infections

skin scraping is taken and KOH is added to it
- examined under a microscope