Dermatology

Question 1

How does eczema present in infants?

Answer 1

Dry, red, itchy and sore patches of skin over the flexor surfaces (the inside of elbows and knees) and on the face and neck.

Question 2

Mx of eczema?

Answer 2

Maintenance:
Soap substitutes
Emollients -
* Thin creams: E45, aveeno, diprobase
* Thick, greasy emollients: hydromol, diprobase, epaderm

Flares:
* Mild: Hydrocortisone 0.5%, 1% and 2.5%
* Moderate: Eumovate (clobetasone butyrate 0.05%)
* Potent: Betnovate (betamethasone 0.1%)
* Very potent: Dermovate (clobetasol propionate 0.05%)

Question 3

What is eczema herpeticum?

Answer 3

A viral skin infx in pts w/eczema caused by HSV or VZV. Pts can be very unwell - derm emergency.

Question 4

How does eczema herpeticum present?

Answer 4

Fever and clusters of itchy blisters or punched-out erosions.

Question 6

What is Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)?

Answer 6

A disproportional immune response causes epidermal necrosis, resulting in blistering + shedding of top skin layer.

SJS - affects <10% of body SA
TEN - affects >10% of body SA

Question 7

Causes of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)?

Answer 7

Medications:
* Anti-epileptics
* Abx
* Allopurinol
* NSAIDs

Infx:
* HSV
* HIV
* CMV
* Mycoplasma pneumonia

Question 8

Sx of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)?

Answer 8

Starts w/non-specific sx - fever, cough, sore throat, sore eyes and itchy skin

Develops into purple/red rash that spreads across skin + blisters. Skin then starts to break away and sheds leaving raw tissue underneath

Question 9

Mx of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)?

Answer 9

Medical emergency - admit to derm
Tx - steroids, immunoglobulins and immunosuppressant

Question 10

Urticaria tx?

Answer 10

Antihistamines - fexofenadine (for chronic urticaria)

If severe flare - oral steroids

Question 11

What is allergic rhinits?

Answer 11

IgE-mediated type 1 hypersensitivity reaction. When environmental allergens cause an allergic inflammatory response in the nasal mucosa.

Examples:
* Hayfever
* House dust mite allergy
* Occupational

Question 12

Sx of allergic rhinits?

Answer 12

Runny, blocked and itchy nose
Sneezing
Itchy, red and swollen eyes