Dermatology

Question 1

Rosacea

Answer 1

Papules, pustules and telangiectasia on an erythematous background

Cheeks, forehead and chin

Question 2

Erysipelas

Answer 2

Indurated skin infection with a well-defined raised edge

Painful

Erythematous

Question 3

Seborrhoeic dermatitis

Answer 3

Red and scaly rash involving

Eyebrows

Eyelids

Nasolabial folds

Question 4

Chloasma / Melasma

Answer 4

Increased browning pigmentation, usually confined to symmetrical areas of the cheeks.

Common in pregnancy

Can be caused by drugs:
*COCP
*Hydroxychloroquine
*Diphenylhydrazine

Question 5

Malar flush

Answer 5

Mitral stenosis

Pulmonary stenosis

Rosacea

SLE

Mesenteric adenitis

Question 6

Spider naevi

Answer 6

Pregnancy

Liver disease

Vitamin B deficiency in normal people

Question 7

Erysipelas vs cellulitis

Answer 7

Erysipelas usually involves the superficial subcutaneous tissue, as a result the skin is hard, red and shiny. It’s usually caused by group A

Cellulitis usually involves the deep tissue resulting in tenderness and swelling. Usually caused by group or Streptococcus pyogenes.

Question 8

Merkel-cell carcinoma definition

Answer 8

aggressive cutaneous
neuroendocrine tumour that is associated with polyomavirus infection,
immunosuppression, advanced age, and sun exposure

Question 9

Features of Merkel-cell carcinoma

Answer 9

Asymptomatic or non-tender
Expanding rapidly
Immune suppressed
Older than 50
UV-exposed fair skin

Question 10

Pyogenic granuloma

Answer 10

Appears as a painless red, brownish-red or blue-black spot. It grows rapidly over a period of a few days to weeks to a final size of 1–2
cm (rarely up to 5 cm). It typically bleeds easily and may ulcerate to form a crusted
sore

Question 11

Melanoma excision protocol

Answer 11

For melanoma in situ, a 5 mm clear margin is desirable.
For melanoma less than 1 mm thickness , a 1 cm clear margin is desirable.
For melanomas 2-4 mm thickness, a 1-2 cm clear margin is desirable.
For melanomas more than 4 mm thickness, a clear margin of 2 cm is required.

Question 12

highest risk for developing malignant melanoma

Answer 12

Multiple dysplastic nevus

Question 13

highest risk of developing squamous cell carcinoma

Answer 13

-Age over 40
-History of non-melanoma skin cancers
-Tendency to burn rather than tan when exposed to the sun
Fair complexion is a risk factor for developing squamous cell carcinoma of the skin however it is not useful in assessing the severity of the risk factors contributing to
the disease

Question 14

Urticaria (hives) characterized by

Answer 14

pruritic, oedematous papules, and plaques that vary in size and come and go, often within hours. Folliculitis caused
by Pseudomonas aeruginosa can cause a rash, often after exposure to hot tubs

Question 15

Treatment of urticaria

Answer 15

Oral promethazine

Question 16

Yellow-colored cutaneous plaques as well as yellow bumps on his elbows and buttocks

Answer 16

Eruptive xanthoma
Xanthomatous skin lesions can be important cutaneous clues for underlying lipid disorders

Question 17

Treatments varicella zoster virus

Answer 17

antiviral (within days)
TCA

Question 18

varicella zoster virus

Answer 18

also known as Shingles

characterized by a painful, unilateral vesicular eruption in a dermatomal distribution. The clinical manifestations of uncomplicated herpes zoster typically include a dermatomal vesicular rash, and acute neuritis, which precedes or occurs simultaneously with the rash.

Question 19

Secondary pellagra due to vitamin B3 deficiency

Answer 19

Due to not enough absorption due to metabolism problems
– Anorexia nervosa.
– Chronic diarrhoea.
– Chronic alcoholism.
– Hartnup disease.
– Carcinoid syndrome
– Colitis.
– Hepatic cirrhosis

Question 20

Primary Pellagra

Answer 20

caused by dietary deficiency of tryptophan or niacin (vit B3)

The classic triad of dermatitis, diarrhoea and dementia is not always present

Question 21

Tinea capitis

Answer 21

Almost exclusively seen in children, main differentiator to alopecia areata

-Black dot ringworm: hairs break off at base leaving “black dots” in hairless patches.
-Grey patch ringworm: circular, scaly, hairless patches develop.
-Seborrheic form: diffuse scale with minimal to no hair loss

Question 22

Squamous cell carcinoma pre-cursor disease

Answer 22

typical actinic keratoses (AK).
Over ten years, there is 6% chance that AK progresses to squamous cell carcinoma.

Question 23

Most common skin cancers hierarchy

Answer 23

Basal cell carcinoma (BCC) is the most common skin cancer, accounting for about
68% of all skin cancers. Squamous cell carcinoma (SCC) accounts for 28%, melanoma 3%

Question 24

Lichen sclerosus

Answer 24

inflammatory condition of the skin.
Bimodal peak: prepubertal
girls, perimenopause.
Pruritus is the main symptom.
Main differential diagnosis is atrophic vaginitis.
First-line treatment includes steroids.
Lifelong surveillance with 6-monthly check-up is required due to the risk of squamous cell carcinoma of the skin

Question 25

Pemphigus vulgaris vs Bullous pemphigoid

Answer 25

PV: flaccid bullae and mucosal erosions

Question 26

Diagnosis of Lichen Planus

Answer 26

commonly occurs as pruritic, purple/pink, polygonal
papules and plaques on the skin of the extremities and trunk (cutaneous LP), but
lesions may also appear on the genitalia (genital LP) (genital LP) or oral mucosa (oral LP). The
lesions often have white, lacy markings known as Wickham striae and can form along the lines of minor trauma

Treatment includes topical high-potency glucocorticoids topical high-potency glucocorticoids (eg, betamethasone). The disorder is self-limited and typically resolves within 2 years.

Question 27

difference between lipoma and epidermoid cyst

Answer 27

characteristic physical feature of a lipoma is the lobulated contour

Question 28

skin malignancies is most likely to arise from a burn scar

Answer 28

Squamous cell carcinoma

Question 29

Amiodarone + Warfarin

Answer 29

Haematoma

Question 30

Coeliac disease causes what rash

Answer 30

dermatitis herpetiform

Question 31

Diagnosis of Ramsay hunt syndrome

Question 32

Cause of Ramsay Hunt Syndrome

Question 33

Treatment of acne

Answer 33

1st line: isotretinoin
2nd line: Doxycycline

Doxycycline helps treat acne by reducing the bacteria that cause acne and decreasing inflammation. It is an antibiotic that targets the bacteria on the skin and in the pores, preventing them from multiplying and causing infections. By reducing these bacteria, doxycycline helps to lower the redness, swelling, and formation of pimples.

Question 34

Most commonly affected nail site on Tinea Unguium

Answer 34

Nail Plate

Question 35

Pattern of lentigo melanoma

Answer 35

slow growing (3 years)