Dermatology

Question 1

What is Urticaria?

Answer 1

• Definition: Urticaria, or hives, is an erythematous, blanching, itchy skin swelling that appears quickly (within minutes) and typically resolves in under 24 hours without skin marks.
• Common Causes: Most often allergy-related; can also have non-allergic triggers.
• Angioedema: Present in ~40% of cases, involving deeper swelling, often affecting the face, lips, and airways, lasting up to 72 hours and may be painful rather than itchy.
• Types:
  • Acute: <6 weeks, often stimulus-triggered and self-limiting.
  • Chronic: ≥6 weeks, typically without a specific trigger.

Question 2

H&E for Urticaria

Answer 2

• Pale, pink raised skin
  
  • Described as ‘hives’, ‘wheals’, ‘nettle rash’
• Pruritis
• Resolution with 24 hours

Other diagnostics:
- Blanching lesions

Question 3

RF for Urticaria

Answer 3

Recent exposure to drug/food trigger, viral infection or insect bite/sting

Drugs that commonly cause urticaria:
- aspirin
- penicillins
- NSAIDs
- opiates

Question 4

Investigations for Urticaria

Answer 4

Bloods:
- FBC, ESR, CRP

Question 5

Management of Urticaria

Answer 5

• Non-sedating antihistamines
• Prednisolone for sever or resistant episodes

Question 6

What are Arterial Ulcers?

Answer 6

Often the result of damage to the arteries due to poor circulation and blood flow

Blood unable to flow into lower extremities like legs and feet

When skin and underlying tissue deprived of oxygen, tissue starts to die off and form an open wound

Question 7

H&E of Arterial Ulcers

Answer 7

• Punched out appearance
• Typically circular with red, yellow or black colouration
• Well defined edges
• On toes and heels
• Pain
• Cold with no palpable pulses
• Could be gangrenous

Question 8

Investigations for Arterial Ulcers

Answer 8

ABPI - will be low

Question 9

Management of Arterial Ulcers

Answer 9

• Keeping wound dry
• Lifestyle changes
• Orthopaedic shoes
• Angioplasty to restore blood flow