DERMATOLOGY

Question 1

what does hypertrichosis mean?

Answer 1

generalised excess hair in no particular patter

androgen independent

Question 2

what skin condition produces antibodies against hemi-desmosome proteins?

Answer 2

bullous pemphigoid

Question 3

elderly patient with erythematous plaques 1 year prior to formation of blisters on trunk and proximal limbs
what is it?

Answer 3

bullous pemphigoid

Question 4

is bullous pemphigoid Nikolysky sign negative or positive?

Answer 4

negative

Question 5

what would you see on immunofluorescence of bullous pemphigoid?

Answer 5

linear IgG and complement along basement membrane

Question 6

what skin condition produces antibodies against desmogelin 3?

Answer 6

pemphigus vulgaris

Question 7

what is acantholysis? what skin condition is it seen in?

Answer 7

separation of individual keratinocytes

seen in pemphigus vulgaris

Question 8

middle aged patient with multiple fragile blisters on scalp, face and axilla and also within the mouth and conjunctivae
what is it?

Answer 8

pemphigus vulgaris

Question 9

is pemphigus vulgaris Nikolsky sign negative or positive?

Answer 9

positive

Question 10

what is seen on immunofluorescence in pemphigus vulgaris?

Answer 10

chicken wire deposition of IgG within the dermis

Question 11

what skin condition produces antibodies against TTG? what other condition is this implicated in?

Answer 11

dermatitis herpetiformis

coeliac disease

Question 12

what is seen on immunofluorescence in dermatitis herpetiformis?

Answer 12

granular deposits of IgA within papillae of epidermis

Question 13

what is hyperkeratosis?

Answer 13

thickening of keratin layer

Question 14

what is parakeratosis?

Answer 14

retention of nuclei in corneocytes

Question 15

what skin condition are hyperkeratosis and parakeratosis part of?

Answer 15

psoriasis

Question 16

what type of T cells are involved in psoriasis and what do they do?

Answer 16

type 1 help T cells stimulate keratinocyte proliferation

Question 17

what histological changes are seen in psoriasis

Answer 17

hyperkeratotic stratum corneum with parakeratosis
absence of granular layer
thickening of prickle cell layer
neutrophil filled abscesses in stratum corneum
large dilated papillary blood vessels

Question 18

what is Auspitz sign in chronic plaque psoriasis

Answer 18

removing scale causes pin point bleeding

Question 19

what is Koebner phenomenon in psoriasis

Answer 19

plaques of psoriasis, similar to chronic plaque disease, develop on trauma site 2-6 weeks after trauma

Question 20

adolescent with scaly erthytematous plaques in tear drop shape on trunk, had cold week before
what is it?

Answer 20

guttate psoriasis

Question 21

elderly patient with erythematous glazed plaques on groin, axilla and under breast
what is it?

Answer 21

flexural psoriasis

Question 22

how is flexural psoriasis different to other types of psoriasis

Answer 22

no scale

Question 23

what signs are seen on psoriatic nail disease

Answer 23

pitting, onycholysis, sublingual hyperkeratosis, dystrophy, oil drop lesions

Question 24

what is the first line topical therapy for psoriasis?

Answer 24

vit D analogues

calciptriol/calcitriol

Question 25

how is dithranol used in psoriasis?

Answer 25

used in short contact regimens for stable chronic plaque disease

Question 26

what disadvantage does dithranol have?

Answer 26

it burns and stains normal skin

Question 27

what type of psoriasis are steroids used to treat?

Answer 27

flexural disease and palmar plantar disease

Question 28

when is salicylate used in psoriasis?

Answer 28

to break down particularly hyperkeratotic skin

Question 29

what type of psoriasis is phototherapy a first first line treatment for?

Answer 29

guttate psoriasis

Question 30

what are the side effects of photodynamic therapy?

Answer 30

sunburn reaction, conjunctivitis, exacerbation of HSV infection

Question 31

when would systemic therapy be used in psoriasis and what would be used?

Answer 31

severe or non responsive disease | methotrexate, ciclosporin, retinoids

Question 32

what are some of the histological findings of dermatitis

Answer 32

``` spongiosis acanthosis hyperkeratosis dilated blood vessels esoinophillic infiltration ```

Question 33

what gene mutation contributes to atopic dermatitis?

Answer 33

fillagrin

Question 34

what is the diagnostic criteria for atopic dermatitis?

Answer 34

``` itch + 3 or more of: visible flexure rash history of flexural rash personal history of atopy dry skin in the part year onset before the age of 2 ```

Question 35

what is the name of the viral infection that in a patient with dermatitis is a medical emergency?

Answer 35

eczema herpeticum

Question 36

what treatment should everyone with atopic eczema have?

Answer 36

emollients

Question 37

what should be given to someone with atopic dermatitis for itch?

Answer 37

ant-histamines

Question 38

what should be given to someone with a flare up of dermatitis?

Answer 38

topical steroids