Dermatology

Question 1

psoriasis primary management?

Answer 1

1. emollients
2. topical steroid + vit D analogue (calcipotriol) - 1st line, applied at separate times of day
3. coal tar

Question 2

psoriasis secondary management?

Answer 2

1. phototherapy
2. oral methotrexate - first line
3. ciclosporin
4. biological agents e.g. infliximab

Question 3

Most common type of melanoma?

Answer 3

Superficial spreading (70%)

Noduler - 2nd most common

Question 4

A lesion on arms, back or legs in a younger patient - most likely type of melanoma?

Answer 4

superficial spreading

Question 5

Most aggressive type of melanoma?

Answer 5

Nodular

Question 6

A lesion on sun exposed skin in middle aged patient which is red/black and/or oozes blood =?

Answer 6

nodular melanoma

Question 7

Melanoma on feet or hands (may affect nail)?

Answer 7

Acral lentiginous

Question 8

How does erythema mulitforme present?

Answer 8

• target lesions
• initially seen on the back of the hands / feet before spreading to the torso
• upper limbs are more commonly affected than the lower limbs
• pruritus is occasionally seen and is usually mild
• following infection

Question 9

How does squamous cell carcinoma of the skin present?

Answer 9

• sun exposed areas
• rapidly expanding, painless, ulcerative nodule
• ‘cauliflower’ appearance
• may bleed

Question 10

Management of squamous cell carcinoma of the skin?

Answer 10

• if <20mm then surgical excision with 4mm margins
• if >20mm then 6mm margins
• Mohs surgery for high risk patients

Question 11

Management of rosacea?

Answer 11

Topical ivermectin

Question 12

Impetigo most commonly caused by?

Answer 12

Staphylcoccus aureus
OR
Streptococcus pyogenes.

Question 13

Golden, crusted lesions found around mouth = ?

Answer 13

impetigo

Question 14

Management of impetigo?

Answer 14

limited, localised disease:
1. hydrogen peroxide 1% cream - 1st line
2. topical fusidic acid
3. topical mupirocin - if MRSA or suspected resistance.

extensive disease:
- Oral flucloxacillin
- Oral erythromycin if penicillin allergy

School exclusion until lesions are healed and crusted over OR 48 hours after starting antibiotics.

Question 15

Lichen planus vs lichen sclerosus?

Answer 15

Planus - purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham’s striae over surface. Oral involvement common

Sclerosus - itchy white spots typically seen on the vulva of elderly women

Question 16

Treatment of lichen planus?

Answer 16

• potent topical steroids
• benzydamine mouthwash or spray is recommended for oral lichen planus
• extensive lichen planus may require oral steroids or immunosuppression

Question 17

most common pathogen in cellulitis?

Answer 17

streptococcus pyogenes
staph aureus (2nd most common)

Question 18

superficial thrombophlebitis management?

Answer 18

NSAIDs - 1st line

Question 19

Which conditions are associated with vitiligo?

Answer 19

addisons disease
type 1 diabetes
autoimmune thyroid disorders