Dermatology

Question 1

An 8-year-old boy is seen in the Paediatric Clinic with multiple episodes of seizures for the past few months. He has an isolated patch of white hair on his head, small, reddish nodules on his face, particularly around nasolabial folds, and several oval hypopigmented-shaped lesions on his abdomen. There are also smooth, firm, flesh-coloured, non-tender lumps growing underneath the nail beds bilaterally. Neurological examination is otherwise unremarkable. Given the history, what is the most likely diagnosis?

-halo naevus
-multiple sclerosis
-neurofibromatosis
-vitiligo
-tuberous sclerosis

Answer 1

Question 2

A 9 month old boy is rushed into the paediatric emergency department with an ongoing seizure which has failed to terminate following initial treatment with buccal midazolam. Following a full DRABC assessment and further treatment with IV lorazepam his seizure is successfully terminated and he is transferred to the paediatric high dependency unit for further management. On review it is noted that he has 4 large hypo pigmented macules each measuring over 2cm in diameter on his back and torso. There is also noted to be angiofibromas on the nose. Ophthalmological examination reveals the presence of a small retinal hamartoma in the right eye. An electroencephalogram (EEG) is requested and shows evidence of hypsarrhythmia. An echocardiogram comes back as normal.

The paediatric consultant requests an MRI head and in the meantime asks you what is most likely to be the diagnosis?

-Neurofibromatosis type 2
-tuberous sclerosis complex
-MEN type 1
-neurofibromatosis type 1
-West syndrome

Answer 2

Question 3

What type of drug is methotrexate?

Answer 3

Anti-folate medication

It inhibits the synthesis of DNA and induces immunosuppression

Question 4

What are the three main conditions Koebner’s phenomenon is seen in?

Answer 4

Psoriasis, lichen planus and vitiligo

Question 5

Answer 5