Dermatology

Question 1

Appearance of Guttate psoriasis

Answer 1

‘Tear drop’, scaly papules on the trunk and limbs

Question 2

Appearance of Pityriasis rosea

Answer 2

Herald patch followed 1-2 weeks later by multiple erythematous, slightly raised oval lesions with a fine scale confined to the outer aspects of the lesions.

May follow a characteristic distribution with the longitudinal diameters of the oval lesions running parallel to the line of Langer. This may produce a ‘fir-tree’ appearance

Question 3

Common complications of seborrhoeic dermatitis

Answer 3

Otitis externa and blepharitis

Question 4

How does Eczema herpeticum present?

Answer 4

Severe primary infection by herpes-simplex-virus 1 or 2, commonly seen in children with atopic eczema.

Presentation with rapidly progressing painful rash (monomorphic punched out lesions 1-3mm in diameter), lymphadenopathy and fever.

Question 5

Presentation of Bullous Pemphigoid

Answer 5

Autoimmune condition causing sub-epidermal blistering of the skin. It is common in elderly patients and is usually itchy.

Question 6

Presentation of Erythema nodosum

Answer 6

Inflammation of subcutaneous fat that typically causes tender, erythematous, nodular lesions.

It typically occurs on the shins. It can be caused by an infection or a systemic disease such as sarcoidosis.

Question 7

Presentation of Stevens-Johnson syndrome

Answer 7

Severe systemic reaction affecting the skin and mucosa, almost always caused by a drug reaction.

The characteristic rash is typically maculopapular with target lesions.

Fever and arthralgia extremely are common.

The condition causes epidermolysis (blistering and peeling) which causes severe fluid loss, causing the patient to feel extremely unwell.

Question 8

What is erythema nodosum associated with?

Answer 8

Systemic diseases such as sarcoidosis, inflammatory bowel disease or streptococcal infection.

Question 9

How is Idiopathic thrombocytopenic purpura (ITP) characterised?

Answer 9

An autoimmune disorder characterised by low platelet count leading to easy bruising and excessive bleeding.

Question 10

How is Thrombotic thrombocytopenic purpura (TTP) characterised?

Answer 10

Rare blood disorder that causes blood clots to form in small blood vessels throughout the body.

This can lead to serious problems if left untreated such as kidney failure and stroke.

The bruises seen in TTP are similar to those seen in ITP - they are usually not painful and often accompanied by other symptoms like fatigue, fever, confusion.