Dermatology

Question 1

What is eczema?

Answer 1

Chronic atopic condition causing inflammation. This is due to defects in the normal continuity of the skin barrier

Question 2

Describe ezcema presentation

Answer 2

dry, red, itchy sore patches of skin - generally on the flexor surfaces - inside of elbows and knees, or on the face/neck. it is often has flares and periods of remission.

Question 3

What other conditions is ezcema associated with?

Answer 3

Atopic conditions - e.g. asthma, hayfever, allergies

Question 4

What is the maintenance management of eczema?

Answer 4

Emollients - thick and greasy to create an artificial barrier over the skin.
Examples - cetraben, diprobasem aveeno cream, E45.

• avoid exacerbators - e.g. washing powders, scented soaps

Question 5

How are ezcema flares managed?

Answer 5

• continue regular emollients and creams
• topical steroids (weakest for shortest period of time) - e.g. hydrocortisone (weak) , dermovate (potent)
• if infected - antibiotics ( most commonly flucloxacillin)

Question 6

What is eczema herpeticum?

Answer 6

A viral skin infection caused by herpes simplex virus or varciella zoster virus.
Usually occurs in patients with pre-exsiting ezcema or dermatitis as the virus is able to enter the skin to cause the infection.

Question 7

How does eczema herpeticum present?

Answer 7

patient with ezcema that has developed
- widespread
- painful
- erythematous
- vesicular rash (spots containing fluid)
- systemic symptoms - fever, lethargy, irritability
- lymphadenopathy

Question 8

How is eczema herpeticum diagnosed?

Answer 8

Viral skin swab - however normally treated on clinical appearance

Question 9

What causes chicken pox?

Answer 9

Varicella zoster virus

Question 10

Describe the presentation of chickenpox?

Answer 10

• widespread, erythematous, raised, vesicular (fluid filled), blistering rash.
• normally starts on trunk or face and spreads outwards, affecting the whole body for 2-5 days.
• lesions then scab over
• fever
• itchiness
• general fatigue

Question 11

Describe the infectivity of chicken pox?

Answer 11

• highly infective through direct contact or infected droplets.
• become symptomatic 10 days - 3 wks after exposure
• no longer contagious when all the lesions have crusted over

Question 12

What are some complications of chickenpox?

Answer 12

• bacterial superinfection + sepsis
• dehydration
• conjunctival lesions
• pneumonia
• encephalitis

Can lay dormant - later reactivated as shingles or Ramsay hunt syndrome

Question 13

How is chickenpox managed?

Answer 13

• usually self limiting
• aciclovir - considered if immunocomprimised / at risk of complications
• can manage symptoms with antipyrexials and antihistamines
• stay off school and avoid pregnant women until all lesions are crusted over

Question 14

What causes hand, foot and mouth disease?

Answer 14

coxsackie A virus

Question 15

What is the incubation time for hand, foot and mouth disease?

Answer 15

3-5 days

Question 16

Describe the presentation of hand, foot and mouth disease

Answer 16

• starts with URTI infection
• after 1-2 days - mouth ulcers - may be on the tongue
• blistering red spots around the body - mainly on the hands, feet and around the mouth - may be itchy

Question 17

How is hand, foot and mouth disease managed?

Answer 17

• supportive - simple analgesia
• resolves itself after a week to 10 days
• avoid transmission as is high contagious