Dermatology

Question 1

What is TEN?

Answer 1

Toxic epidermal necrolysis
Scalded appearance to skin
Systemically unwell/febrile
Nikolsky’s sign the epidermis separates with mild lateral pressure

Question 2

What drugs can cause TEN?

Answer 2

phenytoin
sulphonamides
allopurinol
penicillins
carbamazepine
NSAIDs

Question 3

Features + treatment of Pityriasis (tinea) Versicolor

Answer 3

cutaneous fungal infection caused by Malassezia furfur
trunkal patches of hypopigmentation, pink or brown, scale, mild puritus
may become more obvious with a suntan
manage with keotoconazole shampoo

Question 4

Psoriasis Management

Answer 4

1- potent corticosteroid OD + vitamin D analogue applied OD for 4 weeks
2 - increase vitamin D analogue to BD
3- increase potent corticosteroid to BD for 4 weeks or coal tar preparation OD or BD
4- referral for systemic or phototherapy

Question 5

Scalp psoriasis management

Answer 5

1- potent topical corticosteroids OD for 4 weeks
2- trial different formulation of corticosteroid + topical agent to remove scale e.g. salicylic acid.

Question 6

Face, flexural and genital psoriasis management

Answer 6

mild or moderate potency corticosteroid applied once or twice daily for a maximum of 2 weeks

Question 7

Causes of Stephen Johnson Syndrome

Answer 7

penicillin
sulphonamides (co-trimoxazole)
lamotrigine, carbamazepine, phenytoin
allopurinol
NSAIDs
oral contraceptive pill

Question 8

Three Pregnancy Specific Skin Changes?

Answer 8

1: Atopic eruption of pregnancy - looks like eczema

2: Polymorphic eruption of pregnancy - pruritic, last trimester, lesions often appear in abdominal striae first,
emollients, steroids.

3: Pemphigoid gestationis - pruritic blistering lesions, peri-umbilical region, spreading to the trunk, back, buttocks and arms 2nd or 3rd trimester and is rarely seen in the first pregnancy.oral corticosteroids are usually required.

Question 9

Causes of acanthosis nigricans

Answer 9

type 2 diabetes mellitus
gastrointestinal cancer
obesity
polycystic ovarian syndrome
acromegaly
Cushing’s disease
hypothyroidism
familial
Prader-Willi syndrome
drugs: COCP, nicotinic acid

Question 10

Pityriasis versicolor appearance, caused by , management

Answer 10

Hypopigmented or brown patches , often on torso
Malassezia furfur
kzetokonozole shampoo –> skin scrapings and itraconazole PO

Question 11

What virus causes Molluscum?

Answer 11

MCV - poxvirus

Question 12

What virus causes hand foot and mouth disease?

Answer 12

Coxsackievirus

Question 13

What virus causes slapped cheek syndrome?

Answer 13

Parvovirus B19

Question 14

Dermatitis artefacta vs. Neurotic excoriations?

Answer 14

DA - patient denies they are self induced
NE - patient will admit they are self inflicted

Question 15

Steroid cream potency

Answer 15

Help Every Budding Dermatologist
Mild - Hydrocortisone
Moderate - Eumovate
Potent - Betnovate
Very Potent - Dermovate

Question 16

What are dermatofibromas? (AKA Histiocytoma)

Answer 16

Solid nodules/papules caysedby abnormal growth of histiocyte cells. ‘dimple sign’. often occur at site of insect bite/thorn prick/

Question 17

Pyogenic granuloma

Answer 17

misnomer - benign lesions usually affecting young people

Question 18

pyoderma gangrenosum

Answer 18

neutrophilic dermatosis - painful necrotic ulcers of the lower limbs.
associated with IBD, requires immunosuppression e.g. infliximab

Question 19

fungal nail infections
-causes
-management

Answer 19

dermatophytes 90%
candida 10%
<2 nails - amorolfine lacquer
oral terbinafine or itraconazol for candida

Question 20

What is Pityriasis rosea?

Answer 20

Self limiting rash of young adults
‘heald patch’ usually on trunk followed erythematous scaly patches which may sit along line pf langer

Question 21

Acne rosacea management

Answer 21

flushing only - brimonidine gel
mild to moderate - ivermectin topical (or topical metronidazole or azelaic acid)
moderate to severe - topical ivermectin + oral doxycycline
Rhinophyma/ treatment failure- refer

Question 22

Superficial Spreading Melanoma: Frequency, typically affects, appearance

Answer 22

70%
arms/legs/torso - young people
a growing mole in locations above

Question 23

Nodular melanoma
Frequency, typically affects, appearance

Answer 23

2nd most common melanoma
sun exposed skin, middle aged
red or black lump +/- bleeding/ooze

Question 24

Lentigo maligna melanoma
Frequency, typically affects, appearance

Answer 24

less common
chronically sun exposed skin - older people
a growing moles with diagnostic features

Question 25

Acral lentiginous melanoma

Answer 25

rare
nails, palms, soles. People with darker skin pigmentation
sublingual pigmentation on palms or feet