Dermatology

Question 1

Psoriasis:
- Definition
- Types (5)
- Causes (5)
- Triggers (7)
- Symptoms (4)
- Signs (3)
- Management
- Complications

Answer 1

Psoriasis:

• Definition: inflammatory skin disease where hyperprolif of keratinocytes in epidermis due to T cel cytokine production stimulation. Skin turnover 2-3 days but should be 28 days. Chronic relapsing
• Types: chronic plaque, guttate (papules on trunk/limbs which turns into plaques after strep URTI), nail, seborrhoeic, pustular (systemic)
• Causes: genetics, stress, tonsillitis, trauma, nsaids/b blockers
• Triggers: stress, infection, UV, trauma, drugs (antimalarials, nsaids, acei)
• Symptoms: large erythematous plaques + silver scale on extensors/scalp, itchy, nail pitting/oncholysis, arthropathy
• Signs: auspitz (capillary bleeding where plaques scraped off), koebner (development of psor lesions in areas of skin affected by trauma), residual pigmentation after lesions resolved
• Management: avoid triggers, emollients,
  1st line: topical corticosteroids (hydrocort, cobetasone butyrate), vit d (apply diff times)
  2nd line: PUVA (psoralen + uv therapy) or retinoids to or methotrexate or biologics infliximab
• Complications: mental health, decreases activities, time off school, erythrodermic psoriasis, comorbs (obesity, hyperlipidaemia, htn, t2dm)

Question 2

Impetigo:
- Definition
- Causes (2)
- Complications (6)
- Symptoms (3)
- Investigations
- Management

Answer 2

Impetigo:

• Definition: superficial bacterial infection in child spread via direct contact. Can be primary or due to secondary condition such as eczema
• Causes: staph aures, strep pyogenes
• Complications: cellulitis, post strep glomerulonephritis, sepsis, scarring, scarlet fever, bullous impetigo can lead to staph scalded skin syndrome
• Symptoms: non bullous pustules which rupture causing brown crust around mouth/nose, itchy. Can also be bullous (fluid filled vesicles) more common if <2 where also may be systemically unwell. Can also get ecthyma where ulcers form under the sores
• Investigations: swab MC+S
• Management: topical hydrogen peroxide 5 days and if doesn’t work fusidic acid. If serous oral flucoloxacillin 5 days. If bullous oral abx + oral fusidic acid. No school until lesions crusted over or 48 hours after abx started. Wash sheets / toys to high temp. Keep bites clean and treat skin conditions quickly, don’t share towels

Question 3

Atopic eczema:
- Definition
- Causes
- Triggers
- Symptoms
- Management
- Follow up
- Safety net
- Complications (5)

Question 4

Acne vulgaris:
- Definition
- Causes (3)
- DD (2)
- Symptoms
- Complications (3)
- Management
- Follow up
- Safety net

Question 5

Cutaneous warts:

• Definition
• Symptoms
• Investigations
• Management