Dermatology

Question 1

What is atopic dermatitis?

Answer 1

Probably the most common type.

It is when a genetic barrier dysfucntion causes itchy, dry and inflammed skin
Usually an abnormality in filaggrin expression.

Question 2

What is Seborrheoic dermatitis?How is it treated?

Answer 2

This is found on the face and sclap and is associated with scale patches, often in < 3 months old.

Treament:
Emolliants
Antifungal creams and shampoos
Mild topical steroids (e.g, hydrocortisone)

Question 3

What is discoid dermatitis? How is it treated?

Answer 3

This areas of itchy, dry and inflammed skin are seen in annular/circular patches.

Difficult to treat, needs steroid with antibacterial component

Question 4

What is pomphylx dermatitis?

Answer 4

Vesicles found of palms and soles

Question 5

What is varicose dermatitis?

Answer 5

Dermatitis assocaited with odema and venous insufficiency.

Question 6

How does eczema/dermatitis present?

Answer 6

Red, dry itchy skin which flares and settles.

Often has family history.

Question 7

How does atopic eczema present in infants?

Answer 7

Often starts of their face or neck (most often cheeks) and then can become widespread

Question 8

What pattern does atopic eczema present with in older children?

Answer 8

Flexural pattern mostly, so antrcubital fossae, popliteal foassae, wrists, hands and ankles.

Question 9

What can cause flares in eczema?

Answer 9

Infections
Enviromental triggers: heating, cold air
Pets- if allergic
Teething
Stress
Idopathic sometimes

Question 9

What can cause flares in eczema?

Answer 9

Infections
Enviromental triggers: heating, cold air
Pets- if allergic
Teething
Stress
Idopathic sometimes

Question 9

What can cause flares in eczema?

Answer 9

Infections
Enviromental triggers: heating, cold air
Pets- if allergic
Teething
Stress
Idopathic sometimes

Question 10

What can cause flares in eczema?

Answer 10

Infections
Enviromental triggers: heating, cold air
Pets- if allergic
Teething
Stress
Idopathic sometimes

Question 11

How is eczema treated?

Answer 11

Emollients
Topical steroids
Calcineurin inhibitors (steroid sparing agents e.g. protopic)
UBV light therpy
Immunosuppressive medication

Also suits and mittens can prent scratching and allow emollient more time to absorb.

Question 12

What is a mild usually first line topical steroid?

Answer 12

Hydrocortisone

Question 13

What is a moderate topical steroid?

Answer 13

Eumovate

Question 14

What is the next step up from Eumovate?

Answer 14

Betnovate (potent)

Question 15

What is the strongest topical steroid used?

Answer 15

Dermovate - very potent and rarely used

Question 16

How should you use topical steroids on face?

Answer 16

In more sensative areas e.g face need to limit steroid use. Only used mild or moderate for 3-5 days then stop and repeat if needed.

If need to use regularly switch to a steroid sparing agent e.g. Tacrolimus

Question 17

What are some steroid sparing agents that can be used?

Answer 17

Protropics e.g. Tacrolimus

Question 18

What is impertigo and how is it treated?

Answer 18

Acute superficial bacterial infection, caused by staph aureus.

Pustules and honey coloured crusted erosions seen around nose and mouth.

Treat with:
Topical antibacterial (fucidin)
or
Oral antibiotic (flucloxacillin) if not responding

Question 19

What is molluscum contagiosum and how is it treated?

Answer 19

Common begnin and self limiting pearly papules.
Can take up tp 24 months to clear but usually clear without treatment.

Reassure
Can be treated with potassium hydroxide is very concerned but don’t use if in the area of eczema.

Question 20

How ware viral warts treated?

Answer 20

Usally appear same colour as skin.

Often clear themselves

Can treat with salicylic acid or cyrotheapy or oral zinc

Question 21

What is parovirus?

Answer 21

Also called slapped cheek
Erythematous rash initally appearing on cheeks then lacework like rash on trunk and limbs.

Self limiting, 6 weeks to fade

Question 22

What is eczema herpeticum?

Answer 22

A child witha history of eczema becomes unwell.

Mornomorphic punched out lesions.

treat by:
withholding steroids for 24hrs
Aciclovir - oral or iv

Opthalomology review if near eye