Dermatology

Question 1

Briefly outline the pathophysiology of eczema

Answer 1

Filaggrin mutation which forms part of stratum corneum

Trans-epidermal water loss = dry skin prone to penetration

Question 2

Give 3 general aims of eczema treatment

Answer 2

Improve barrier

Avoid irritants

Reduce itch

Question 3

What is Irritant contact napkin dermatitis?

Answer 3

Moisture and friction disrupt skin barrier allowing irritation from faeces and urine

Question 4

How does Irritant contact napkin dermatitis present?

Answer 4

Glazed erythema that spares skin folds and can wrinkle and scale while it resolves

Question 5

Give 3 management methods for Irritant contact napkin dermatitis

Answer 5

Frequent nappy changes

Avoid soap and wipes

Greasy emollient

Question 6

What is vulvitis?

Answer 6

Itch, erythema and discharge in pre-pubertal girls

Question 7

How does discoid eczema present?

Answer 7

Demarcated plaques often crusted and weeping due to bacterial infection

Question 8

Give 2 management options for discoid eczema

Answer 8

Emollient

Potent steroid

Question 9

What is lip lick dermatitis?

Answer 9

Peri-oral eczema caused by drying of lips

Question 10

What is pityriasis alba?

Answer 10

Hypopigmentation with dry skin on cheeks mainly seen in coloured skin

Question 11

What is Juvenile Plantar Dermatosis?

Answer 11

• Plantar surface of anterior 1/3 of foot erythematous, hyperkeratotic and fissuring mainly due to sweating

Question 12

Give 3 management options for Juvenile Plantar Dermatosis

Answer 12

Avoid tight shoes

Aluminium hydrochloride powder

Urea emollients

Question 13

What are the main principles of HSV infection in children?

Answer 13

Periorbital involvement treated with acyclovir and eyes checked for corneal involvement

Question 14

What is impetigo and how does it present?

Answer 14

Staph. aureus infection with honey coloured crusts which may become bullous

Question 15

How is impetigo treated?

Answer 15

Topical/oral flucloxacillin

Question 16

What are Molluscum Contagiosum?

Answer 16

Small pearly papules affecting 4-9 y/o caused by DNA Pox virus

Question 17

Give 4 places in which scabies may burrow in children

Answer 17

Soles of feet
Axilla
Groin
Penis

Question 18

What is Tinea Capatis?

Answer 18

Fungal infection causing - diffuse scale to patchy alopecia with black dots or pustules associated with lymphadenopathy

Question 19

What is the name of yellowish white pinpoint lesions around nose of newborns?

Answer 19

Sebaceous Hyperplasia

Question 20

What are Milia?

Answer 20

Discrete whiteish yellow papules on chin, cheeks and forehead

Question 21

What are the two types of militia?

Answer 21

Miliaria Crystalina: superficial duct obstruction

Miliaria Rubra: erythematous papules

Question 22

What is Mongolian Spot?

Answer 22

Lower back/sacrum of neonates due to deep dermal melanocytes

Question 23

What is epidermal navei?

Answer 23

Linear plaques on warty pigmented skin along Blaschkos lines

Question 24

When do infantile haemoangioma’s develop?

Answer 24

First 6 weeks of life

Question 25

What is Port Wine stain? (capillary malformations)

Answer 25

Present at birth and bright red but fade over time

Question 26

What can Port wine stains be part of the triad of?

Answer 26

Sturge Webber syndrome

Question 27

Define urticaria

Answer 27

Itchy hives and plaques and surrounding erythema

Question 28

How long does acute urticaria last?

Answer 28

Less than 6-8 weeks

Question 29

Give 4 general triggers of acute urticaria

Answer 29

Infection
Infestation
Injection
Inhalation

Question 30

What is the treatment of chronic urticaria?

Answer 30

Chlorpheniramine <6 months + long-acting antihistamine if > 6 months