Dermatology

Question 1

Medication that can exacerbate psoriasis.

Answer 1

ACEi

Question 2

Auspitz’ Sign

Answer 2

Superficial scraping of the lesion causes pinpoint bleed

Question 3

Treatment of Psoriasis

Answer 3

First Line:
- Topical Corticosteroid
- Emollients
- Vitamin D Analogues

Second Line:
- Phototherapy (PUVA)

Question 4

Psoriatic Arthritis

Answer 4

• Symmetric Polyarthritis
• Rheumatoid Arthritis pattern, but RF NEGATIVE
• DIP most involved

Question 5

Treatment of Psoriatic Arthritis

Answer 5

NSAIDS
DMARDs (Methotrexate, Sulfasalazine and Leflunomide)

Question 6

Aspect of Plaque Psoriasis

Answer 6

Plaques, covered in Silver scales

Most common type of Psoriasis

Question 7

Aspect of Guttate Psoriasis:

Answer 7

Small (less than 1 cm), drop-shaped lesions

Usually dissapears completely after a few weeks. Some may go on to develop plaque psoriasis

Question 8

What are the presentations of Liquen Planus?

Answer 8

Cutaneous Liquen Planus and Oral Liquen Planus

Question 9

What is Erosive Liquen Planus?

Answer 9

A type of Oral Liquen Planus where, along with the striae, the patient develops painful ulcers that can last weeks or years

Question 10

What is the presentation of Cutaneous Liquen Planus?

Answer 10

Purple
Pruritic
Papular
Polygonal Rash

Commonly seen on Flexor Surfaces

Question 11

Management of Liquen Planus:

Answer 11

Symptomatic:
- Itching = Topical Steroids and Antihistamines

Question 12

What is the presentation of Oral Liquen Planus?

Answer 12

White lacy pattern on buccal mucosa and sides of the tongue - Wickham Striae

Question 13

What is Cellulitis?

Answer 13

An infection of the dermis and subcutaneous tissues, that has POORLY DEMARCATED BORDERS.

Question 14

Presentation of Cellulitis

Answer 14

• Erythema
• Warmth
• Swelling and pain on the affected limb

Most common in the Lower Limb

Question 15

Risk Factors for Cellulitis

Answer 15

• Diabetes
• Immunodeficiency

Question 16

Cellulitis is commonly caused by which microorganism(s)?

Answer 16

• Streptococcus
• Staphylococcus

Question 17

Management of Cellulitis

Answer 17

First Line:
- Flucloxacilin 500 mg QDS

Penicilin allergy:
- Clarithromycin 500 BD

MRSA:
- Vancomycin

➜ Analgesics and limb elevation

Question 18

What is Erysipela?

Answer 18

An infection of the upper dermis and upper subcutaneous tissues, with sharply demarcated borders.

Common affected areas = Face - Leg - Arm

Question 19

What is the presentation of Erysipela?

Answer 19

• Fiery-red, indurated, tense and shiny plaque
• Burning sensation over the affected area

Question 20

Management of Erysipela

Answer 20

• First Line: Flucloxacilin 500mg QDS
• Penicillin allergy: Erythomycin or Clarithromycin
• Analgesics and Limb Elevation

Question 21

Presentation of Urticaria

Answer 21

Skin rash with red, raised and itchy bumps

Question 22

Triggers for Urticaria

Answer 22

• Allergies: food, drugs, bee sting
• Skin contact with latex or metals
• Rubbing the place

Question 23

Management of Urticaria

Answer 23

• Antihistamines: Ceterizine or Loratadine (non-sedating)
• Calamine lotion
• Oral Prednisolone (severe cases)

Question 24

Presentation of Malignant Melanoma

Answer 24

A: Asymmetry
B: Border Irregularity
C: Colour Irregularity
D: Diameter >/= 7 mm
E: Evolving

Risk Factors: Sun exposure; fair skin
Melanomas can be raised of flat
Melanomas sometimes are itchy and can bleed
Can occur anywhere, including areas not exposed to sun

Question 25

Management of Malignant Melanoma

Answer 25

**GP Clinic:** - Refer Urgently to Dermatology **Early Stages:** - Surgical Excision **Late Stages:** - Radiation and Palliative Care

Question 26

When diagnosing a Malignant Melanoma, what parameter is most strongly correlated with prognosis?

Answer 26

Depth of Invasion (Breslow Thickness)

Question 27

What’s the most common skin cancer?

Answer 27

**Basal Cell Carcinoma** * Head and Neck are most commonly involved * Least aggressive form of skin cancer * Often has tiny blood vessels (Telangectasias) * Can develop a central depression * Sometimes itchy and can bleed * Commonly located on sun-exposed areas: face, ears, neck

Question 28

Presentation of Basal Cell Carcinoma

Answer 28

***Initially***: Pearly Lesion **Later**: Rodent Ulcer with an indurated and rolled edge and ulcerated center ## Footnote Sun exposure is a risk factor

Question 29

Management of Basal Cell Carcinoma

Answer 29

Surgical Excision Mohs’ Micrographic Surgery