Dermatology

Question 1

What is the cause of chickenpox?

Answer 1

Varicella zoster virus

Question 2

Describe the spread of the rash in chickenpox.

Answer 2

Starts on the trunk or face and spreads outwards to the rest of the body

Question 3

What are the clinical features of chickenpox?

Answer 3

1st symptom: Fever
Itch
Rash
General fatigue and malaise

Question 4

What are the potential complications of chickenpox?

Answer 4

Bacterial superinfection
Dehydration 
Conjunctival lesions
Pneumonia 
Encephalitis (presents as ataxia)

Question 5

How should chickenpox be managed?

Answer 5

Self-limiting, recommend calamine lotion for itching

Aciclovir - immunocompromised, adults, adolescents >14, neonates, high-risk patients

Stay off school until lesions crust over

Question 6

Describe the appearance of the rash in chickenpox.

Answer 6

Widespread
Erythematous
Raised vesicular, blistering lesions

Question 7

What is the cause of hand, foot, and mouth disease?

Answer 7

Coxsackie A16 virus

Question 8

Describe the typical presentation of hand, foot, and mouth disease.

Answer 8

Starts with viral URTI symptoms (tiredness, sore throat, dry cough, fever)
After 1-2days mouth ulcers appear, particularly on the tongue
Followed by blistering red spots across the body
Spots are most notable on hands, feet, and around the mouth
Rash may be itchy

Question 9

What is the management for hand, foot and mouth disease?

Answer 9

Supportive - adequate fluids and analgesia

Resolves spontaneously in 7-10 days

No isolation required

Question 10

What are the potential complications of hand, foot and mouth disease?

Answer 10

Dehydration
Bacterial superinfection
Encephalitis

Question 11

What is the cause of measles?

Answer 11

Measles virus

Question 12

Describe the spread of the rash in measles.

Answer 12

Starts on the face (usually behind the ears) 3-5 days after a fever
Then spreads to rest of body

Question 13

Describe the appearance of the rash seen in measles.

Answer 13

Erythematous, macular rash with flat lesions

Question 14

What are the clinical features of measles (beside a rash)?

Answer 14

Fever
Coryzal symptoms
Conjunctivitis
Koplik spots (pathognomic for measles)

Question 15

What is the management for measles?

Answer 15

Supportive

Isolate until 4 days after symptoms resolve

Question 16

What are the potential complications of measles?

Answer 16

Pneumonia
Diarrhoea
Dehydration
Encephalitis
Meningitis
Hearing loss
Vision loss
Death

Question 17

What is the cause of scarlet fever?

Answer 17

Streptococcus pyogenes (produced by group A streptococcus)

Question 18

Describe the spread of the rash in scarlet fever.

Answer 18

Starts on the trunk and spreads outwards

Question 19

Describe the appearance of the rash seen in scarlet fever.

Answer 19

Red-pink, blotchy, macular rash

Texture of skin described as rough “sandpaper” skin

Question 20

What are the other clinical features of scarlet fever (besides a rash)?

Answer 20

Fever
Lethargy
Flushed face
Sore throat
Strawberry tongue 
Cervical lymphadenopathy

Question 21

What is the management for scarlet fever?

Answer 21

Phenoxymethylpenicillin (Penicillin V) for 10 days

Children should be isolated until 24h after starting abx

Question 22

What is the cause of rubella?

Answer 22

Rubella virus

Question 23

Describe the spread of the rash seen in rubella.

Answer 23

Starts on the face and spreads to the rest of the body

Question 24

Describe the appearance on the rash seen in rubella.

Answer 24

Erythematous macular rash that lasts ~3 days

Question 25

What are the other clinical features of rubella (other than rash)?

Answer 25

Mild fever
Joint pain
Sore throat
Suboccipital and postauricular lymphadenopathy

Question 26

What is the management for rubella?

Answer 26

Supportive

Children should be be isolated for at least 5 days after the rash appears

Question 27

What are the potential complications of rubella?

Answer 27

Thrombocytopenia
Encephalitis
Congenital rubella syndrome

Question 28

What are the features of congenital rubella syndrome?

Answer 28

Deafness
Blindness
Congenital heart disease

Question 29

What is the cause of erythema infectiosum?

Answer 29

Parvovirus B19

Question 30

Describe the spread of the rash seen in erythema infectiosum.

Answer 30

Diffuse rash on both cheeks which may spread to trunk and limbs

Question 31

Describe the appearance of the rash seen in erythema infectiosum.

Answer 31

Slapped cheek disease
Diffuse bright red rash on both cheeks
Reticular mildly erythematous rash affecting the trunk and limbs - can be raised and itchy

Question 32

What are the other clinical features of erythema infectiosum (other than rash)?

Answer 32

Mild fever
Coryza
Non-specific viral symptoms (muscles aches, lethargy)

Question 33

What is the management for erythema infectiosum?

Answer 33

Supportive

No isolation required

Question 34

What are the potential complications of erythema infectiosum?

Answer 34

Aplastic anaemia
Encephalitis or meningitis
Pregnancy complications such as foetal death
Rare: hepatitis, myocarditis, nephritis

Question 35

What is the cause of roseola infantum?

Answer 35

Most common: HHV 6

Less common: HHV 7

Question 36

Describe the distribution of the rash in roseola infantum.

Answer 36

Affects arms, legs, trunk and face

Question 37

Describe the appearance of the rash seen in roseola infantum.

Answer 37

Mild erythematous macular rash

Not itchy

Question 38

What are the other clinical features of roseola infantum (besides rash)?

Answer 38

Coryza
Sore throat
Lymphadenopathy

Question 39

What is the management for roseola infantum?

Answer 39

None - full recovery within a week

No isolation required

Question 40

What are the potential complications of roseola infantum?

Answer 40

Febrile seizures

Complications in immunocompromised:
Myocarditis
Thrombocytopenia
Guillain-Barre syndrome