Dermatology

Question 1

What is the management of pityriasis versicolour?

Answer 1

ketoconazole shampoo
or selenium sulfide shampoo

Question 2

What are the features of alopecia areata?

Answer 2

• well demarcated circular patches of hair loss
• painless, no erythema, no scarring
• ## classic exclamation mark hairs

Question 3

What is the medical term for male pattern baldness

Answer 3

Androgenetic alopecia

Question 4

What is the mechanism for Minoxidil?

Answer 4

direct arteriolar vasodilator

Question 5

What is Bowen’s disease and how is it treated?

Answer 5

Red scaly patch
Can develop into SCC

Tx: 5-fluorouracil (Efudix) cream a type of topical cytotoxic chemotherapy. Also used to treat acitinic keratosis

Question 6

squamous cell carcinoma (SCC) vs BCC

Answer 6

SCC
- typically red
- grows at much faster rate than BCC
- more likely to metastasise
- can have a cauliflower appearance, bleed or ulcerate
- histology: keratin pearls

BCC
- shiny or pearly surface
- central ulceration - raised pale border
- rolled edge
- overlying telangiectasia

Question 7

Behçet’s disease

Answer 7

• vasculitis
• mouth and genital ulcers
• skin lesions such as papules, pustules and erythema nodosum

Question 8

What is Keratocanthoma?

Answer 8

• ?a type of SCC
• rapidly growing
• dome shaped with a central keratin plug
• volcano appearance
• grows quickly, necroses, resolves with some scarring

Question 9

actinic keratosis can lead to what?

Answer 9

• it is a pre-cancerous lesion
• can turn into SCC squamous cell carcinoma
• raised, rough, scaly lesion
• ons unexposed areas such as face and scalp

Question 10

what is the treatment for actinic keratosis?

Answer 10

cryotherapy or topical 5-fluorouracil.

Question 11

features of squamous cell carcinoma

Question 12

molluscum contagiosum

Answer 12

• most common in children
• contagious via skin to skin contact
• clusters of raised, dome-shaped, shiny papular lesions with a dimple in the middle
• harmless and self limiting
• caused by pox virus

Question 13

what is pityriasis rosea?

Answer 13

Pityriasis rosea is a harmless rash

1. starts with a “herald patch” - an oval patch of scaly skin - that can be up to 10cm
2. then you get smaller lesions - small, scaly spots in a symmetrical pattern - giving a Christmas tree appearance of distrubution

self limiting

Question 14

What are the features of malignant melanoma?

Answer 14

• usually dark, pigmented lesion but less commonly can be skin coloured

Suspect melanoma when you have a lesion that is
- asymmetrical edges
- colour variance in the lesion
- changing in size, change or colour
- can be pruritic , sometimes bleed

In women more common in the calf
In men more common in the trunk

Question 15

erythema nodosum is associated with which conditions?

Answer 15

Inflammatory condition of subcutaneous fat (panniculitis) resulting in tender erythematous nodules, often over the shins Associated with: streptococcal infection
drugs
sarcoidosis
tuberculosis
- inflammatory bowel disease

Question 16

pyoderma gangrenosum is associated with which conditions?

Answer 16

• inflammatory bowel disease

Question 17

Livedo reticularis Is associated with which conditions?

Answer 17

polyarteritis nodosa

Question 18

dermatitis herpeteformis is associated with which condition?

Answer 18

coeliac disease

Question 20

Features of venous ulcers

Answer 20

• commonly located in the medial or lateral malleolus
• shallow with irregular borders
• granulation tissue present
• associated with other signs of venous insufficiency like skin hyperpigmentation or lipodermatosclerosis
• usually painless

Question 21

Features of arterial ulcers

Answer 21

• punched out appearance - well demarcated
• little or no granulation tissue
• pain at rest
• pain with elevation
• surrounding skin is shiny or tight
• limb may be cool with reduced or absent pulses
• sensation is intact

Question 22

Features of neuropathic ulcers

Answer 22

• occur due to peripheral neuropathy most commonly due to diabetes or b12 deficiency
• punched out appearance
• most commonly located in plantar metatarsal heads
• you may have warm feet and good pulses unless there’s also arterial disease