Dermatology

Question 1

First line treatment acne

Answer 1

Epiduo (adapalene and BPO)

Question 2

Second line acne

Answer 2

Duac (clindamycin and BPO) or Trecilin (clindamycin + tretinoin)

Question 3

Single agents to combine with oral abx

Answer 3

BPO
Adapalene (retinoid)
combination of above
Azelaic acid

Question 4

Oral abx used for acne

Answer 4

Lymecycline 408od
Doxy 100 od

Question 5

Contraceptive pill good for acne

Answer 5

Eloine® or Mercilon® 1st line,or alternatively Dianette® 2nd line
if not C/I. Consider tricycling for 9 weeks then 4-7 day break (note VTE risk is greater if stopping and starting vs continuous use)

Question 6

Rosacea treatment for the redness

Answer 6

bromonidine
causes temporary reduction in the redness
mild - ivermectin/ metro cream
moderate - ivermectin + oral doxy
severe - refer to dermatology

Question 7

Pemphigus vulgaris

Answer 7

Autoimmune disease
flaccid blisters - break easily
blisters mainly on trunk, face and scalp
Mucosal involvement - initial presentation
diagnosis - skin biopsy

Question 8

Sunscreen prescription criteria for who?

Answer 8

Photodermatoses, vitiligo and those resulting from radiotherapy
More than spf30 prescribed

Question 9

Erythema nodosum causes

Answer 9

Lymphoma
IBD
Rhetmatoid arthritis, SLE
Infections e.g. TB, streptococci
Sarcoid
Drugs e.g penicillins
sulphonamides
combined oral contraceptive pill

Question 10

Bullous pemphigoid

Answer 10

Rare condition common in elderly
can be triggered by trauma, furosemide, NSAIDS and antibiotics
more common in elderly >60
Tense blisters don’t break easily
very itchy
urgent refer to dermatology
Diagnosis by biopsy and direct immunofluorescence
Treatment with steroids/ immunosuppressants

Question 11

SLE

Answer 11

Can be triggered by hydralazine and D-penicillamine
More common Iin female
more common in african-american, American-indian or asians
Most cases seen in women of childbearing age
multifacotorial
Skin, joints, renal, neurological
increase cardiovascular risk

Question 12

Erythema multiform triggers

Answer 12

Infections e.g herpes, mycoplasma
medications e.g. sulfonamides, anti-epileptics, allopurinol,NSAIDs
Oral contraceptice pill
SLE
Sardcoid
Malignancy

Question 13

Rash in Lyme disease

Answer 13

erythema migrans bull’s eye rash

Question 14

Drugs that commonly cause Steven Johnson syndrome

Answer 14

Co-trimaxozole
penicilins, cephalosporins
lamotrigine, carbamezapine, phenytoin, phenobarbital
allopurinol
paracetamol/ acetaminophen
NSAIDs

occur within 1st week of starting, but can be uptp 2 months

Question 15

Lichen Planus

Answer 15

Purple
Pruritic
Papular
Polygonal rash on flexural

Question 16

Which topical medication has a side effect causing flue like symptoms?

Answer 16

Imiquimod

Question 17

Lichen plants drug eruptions

Answer 17

Gold, quinine, thiazides