derm treatments

Question 1

rosacea: moderate to severe papules and/or pustles

Answer 1

topical ivermectin + oral doxy

Question 2

rosacea: mild to moderate pustules and/or papules

Answer 2

1st line: ivermectin

alternative: topical metronidazole or azaelic acid

Question 3

rosacea: predominant erythema/flushing but limited telangiectasia management

Answer 3

topical brimonidine gel, used on an “as required” basis

(its an alpha adrenergic agonist)

Question 4

rosacea
simple measures management

Answer 4

-recommended daily application of a high factor sunscreen

• camouflage creams to conceal redness

Question 5

psoriasis primary care management

(1st-3rd line and 5 points overall)

GIVE DRUG NAMES

Answer 5

all patients use emollient to reduce scale & itch

-1st line: potent topical corticosteroid OD (eg betnovate) + topical vitamin D OD (eg. dovonex) applied at diff times

allow 4 weeks b4 starting seond line treatment
- 2nd: stop the topical corticosteroid, apply topical vitamin D twice daily

• 3rd: stop the topical vitamin D, apply potent topical corticosteroid twice daily

Question 6

psoriasis secondary care management

Answer 6

Phototherapy
- UVB- classic/plaque and especially for guttate psoriasis
- PUVA - used in cases not responsive to UVA

Systemic therapy - immunosuppressive (e.g. methotrexate), immune modulation e.g. biologics
- Usually reserved for severe or non-responsive disease

Question 7

Gas gangrene antibiotic treatment

and the common causitive organism for it

Answer 7

IV penicillin and clindamycin

clostridum perfinges which is g+ anaerobe

Question 8

Treatment for raynauds
name of drug

Answer 8

Calcium channel blocker

eg. nifedipine

Question 9

bullous pemphigoid treatment

Answer 9

Oral costicosteroid mainstay of treatment
topical costicosteroids, immunosuppressants and antibiotics are also used

Question 10

venous ulceration treatment
include the drug name
(3 points)

Answer 10

1) compression bandaging!
- oral pentoxifylinne, a peripheral vasodilator, improves healing rate

Compression stockings to be offered once ulcer has healed

Question 11

seborrheaoic dermatitis: scalp treatment

Answer 11

1st line- zinc pyrithione (head & shoulders) and tar (neutrogena t/gel)
2nd- ketoconazole

Question 12

seborrheaoic dermatitis: face and body management

Answer 12

1st) ketoconazole
2) topical steroids- short periods

Question 13

1st line acute uticaria management
(2 lines of management)

Answer 13

1st: non sedating anti histamine, (cetrilizine, lotradine)
2nd: oral prednisolone (short course and minimal dose)

Question 14

keloids treatment

Answer 14

1st: intra lesional steroids
2nd: occasionally exscision (may lead to further scarring)

Question 15

pityriasis versicolor treatment
(hypopigmented lesions on trunk)
(2 points)

Answer 15

1st: ketaconzole shampoo (anti fungal topical treatment)
2nd: if not working take scrapings to find other diagnosis + oral itraconazole

Question 16

pyoderma gangrenosum managment
(2 points)

Answer 16

1st line: oral steroids
2nd: ciclosporin and infliximab

(avoid sugrery till disease is under control)

Question 17

lichen planus treatment

treatemtn for oral lichen planus too
give drug name

(3 points)

Answer 17

1st line: potent topical steroids (eg. clobetasone butyrate)
2nd: oral steroids/immunosupression

oral lichen planus: benzydamine mouthwash/spray

Question 18

shingles treatment
(3 points)

Answer 18

1st line: oral aniviral within 72 hrs of onset (famciclovir etc)
(contraindicted in <50y w/ mild truncal rash)

& analgesiacs anf NSAIDs
2nd: amitrypitline (neuroblocker for pain if analegsiacs not working)

Oral costicosteroids within 2 weeks, if patient is severely affected and not immunocomprimised

Question 19

eczema herpitcum what is it?

treatment

Answer 19

child, hsv infection w/ eczema, punched out lesions w/ heamorraghic crusts

admit to hospital and give IV acriclovir

Question 20

acitinic keratosis treatment

Answer 20

diclofenac,
5 flourauracil…

Question 21

head lice treatment

Answer 21

malathion

Question 22

nail infection caused by trichophyton rubrum (dermatophyte) treatment

Answer 22

1st line: amorolfine nail laquer for 3-6 months (<50% of nail affected, </=2 nails aff.)
2nd line (for more extensive disease): oral terbifine

Question 23

extensive nail infection (due to candida) treatment

Answer 23

oral itraconazole

Question 24

scabies treatment

Answer 24

1st line: permetherim
2nd line: malathion

Question 25

lichen sclerosus treatment

Answer 25

topical steroids and emollients

Question 26

tinia corpis treatment (ringworm)

give example of drug

Answer 26

topical antifungal - eg terbinafine. if it doesnt go away aftre 2 weeks then take scrapings

Question 27

cellulitis tx.

include if pregnant

Answer 27

1st line: oral flucloxacillin

oral clarithromycin, erythromycin (in pregnancy)

or doxycycline those tht r penicillin allergic

Amit and give IV antibiotics if severe/systemically unwell

Question 28

impetigo tx

Answer 28

1st line: hydrogen peroxide 1%

2nd line: topical fusidic acid

extensive disease: oral flucox

Question 29

tinea pedis tx (aka athetes foot)

Answer 29

topical miconcazole, undecenoate or terbinafine first line

Question 30

mild to moderate acne treatment

Answer 30

fixed combination of topical benzoyl peroxide with topical clindamycin

applied once daily in the evening

Question 31

moderate to severe acne treatment

Answer 31

fixed combo of topical adalpene w/ topical benzoyl peroxide (ODE) + lymecycline/doxcy

not for pregnant women

Question 32

when is metronidazole used for rosacea?

Answer 32

If women is pregnant or breastfeeding as ivormectin is contraindicted then

Question 33

tx for pityriasis rosea

Answer 33

self limiting, conservative management

Question 34

psoriasis flexural surfaces tx

Answer 34

mild topical corticosteroid

Question 35

CHILD scalp seborrhoeic dermatitis (cradle cap) tx

Answer 35

1st line: emollient
2nd: if persistes topical antifungal cream

Question 36

dermatitis herpetiformes tx

Answer 36

1st: gluten free diet
2nd: dapsone
3rd: topical/oral steroids

Question 37

definitive mam