Dermatology

Question 1

A child presents with acute onset hair loss in a smooth ovoid pattern. There is a family history of celiac disease. What investigation would you like to do?
A. ESR
B. TSH
C. ANA
D. Skin scraping

Answer 1

TSH. This is alopecia areata. A and C are wrong. D would be for tinea capitis but this should be scaly NOT smooth like in alopecia areata. Alopecia areata is associated with autoimmune thyroid disease so consider evaluating thyroid function and thyroid antibodies.

Question 2

What is comprised by PHACE syndrome?

Answer 2

Posterior fossa anomalies
Hemangioma
Arterial lesions
Cardiac abnormalities/aortic coarctation
Eye abnormalities

Question 3

An infant presents with a segmental hemangioma of the face. What tests do you order?

Answer 3

Segmental hemagioma of the face or facial hemangioma >5cm: PHACE W/U

• MRI/MRA
• Echo for aortic arch abnormalities
• Ocular examination

Question 4

An infant presents with a hemangioma in the beard distribution. What should you be concerned about?

Answer 4

Hemangiomas involving the ‘beard’ area such as the neck, lower lip, chin, preauricular and mandibular area are at increased risk of airway involvement and requires ENT evaluation.

Question 5

What are the indications for treatment of an hemangioma?

Answer 5

When it imposes a possible functional impairment such as:
-Obstruction of vision
-Obstruction of hearing
-Nasal deformity
-Parotid involvement
-Airway involvement
-Significant liver involvement
Or Ulceration

Question 6

What is the triad of Sturge-Weber?

Answer 6

Port Wine Stain, glaucoma, and leptomeningeal angiomatosis associated with seizures