Dermatology

Question 1

Compare basal cell and squamous cell carcinoma

Answer 1

Squamous cell: Papule then nodule sized ulcer

BCC: Pearly rolled edge, telangectasia, necrotic or ulcerated centre

Question 2

Compare acne vulgaris and rosacea in terms of

Age

Common sites

Lesion features

Answer 2

Vulgaris // Rosacea

Young adults // 30-60 years

Face, chest, back // central face

Comedones, inflammed lesions // lumpy red skin, telangectasia

Question 3

What is the initial treatment course for acne vulgaris

Answer 3

12 weeks of the following regimes

Mild-moderate

A + B: Adapelene + Benzoyl peroxide

B + C: Benzoyl + clindamycin

C+ T: Clindamycin + Tretinoin

Mod-severe

A+B

C+T

A+B + doxy/tetracycline

Azelaic acid + lymecycline

Question 4

Outline the step-up and referral criteria for acne vulgaris management?

Answer 4

1st line fails: try another regime, add antibiotics

Refer: If abx fails, uncertainty or extenive nodules

Question 5

Regarding ABx therapy in acne vulgaris what

Is given instead of doxycline/tetracyclines contraindicated

Can be given to menstruating women instead of ABx

Answer 5

Trimethoprim or oral macrolide

COC pill

Question 6

Whats the treatment for acne rosacea

Answer 6

1st: topical metroniazole (tetracycline)

Question 7

How do you differentiate the following psoriasis

Plaque

Inverse

Guttate

Answer 7

Question 8

What is the treatment for psoriasis

Answer 8

1. topical steroid + vitamin D analogue at different time
2. Stop steroid, 2 x vit D
3. Stop vit D, 2 x steroid

+ dithranol/coal tar

Question 9

Whats this?

How do you manage it

Answer 9

Lichen planus

Skin biopsy

Corticosteroids

Question 10

Whats this?

Answer 10

Wickham’s striae

Seen in Lichen planus

Question 11

How do you differentiate sebhorreic keratosis with malignant melanoma?

Answer 11

Sebhorreic // melanoma

Multiple, asymptomatic // evolving, itching, bleeding

Variable sites // legs in women, trunk in men

Warty, greasy appearance // ABCDE features

Nothing // Excise

Question 12

Differentiate vulgaris, pemphigoid and herpetiformis based on…

Pain and itch

Tension

Immune findings

Treatment

Answer 12

vulgaris // pemphigoid // herpetiformis

pain // itch // very itchy

Flaccid // tense // tense

IgG, chicken wiring // IgG, C3, dermo-epidermal junction lights up // IgA and IgG, granular pattern, villous atrophy

Steroids + immuno // Steroids, antibiotics, immuno // gluten exclusion, dapsone

Question 13

What is the treatment for scabies?

Answer 13

Permethrin

Malathion

Question 14

Target lesions following drugs or infection indicates what?

Answer 14

Erythema multiforme

Question 15

What is the Koebner phenomenon and what does it occur in?

Answer 15

Trauma causes dermatomal line, happens in

psoriasis

vitiligo

warts

lichen planus

lichen sclerosus

molluscum contagiosum