Dermatology

Question 1

Itchy rash face scalp eyebrows

Answer 1

seborrhoeic dermatitis

Question 2

Red rash affecting face, with flushing, non-pruritic.
Can cause blepharitis/conjunctivitis

Answer 2

Acne Rosacea

Question 3

1st line Tx for Acne Rosacea

Answer 3

Topical Ivermectin

(Brominidine gel, an alpha agonist, can be used PRN for flushing)

Question 4

Red rash with silver scale/plaque

Answer 4

Psoriasis

Question 5

Treatment for extensor psoriasis

Answer 5

Potent topical steroid + Vitamin D analogue (latter reduces plaque thickness)

Question 6

Treatment for flexural psoriasis (incl groin/axilla/face)

Answer 6

Mild topical steroid only

(since skin thinner in flexures, so is plaque, so vitamin D no benefit)

Question 7

Treatment for keloid scarring?

Answer 7

Intralesional steroid (triamcinolone)

Question 8

Fungal nail infection involving <50% nail or 2 or fewer nails?

Answer 8

Topical anti fungal nail cream

Question 9

Fungal nail infection involving >50% nail or more than 2 nails?

Answer 9

Oral terbenafine

Question 10

There are 4 skin conditions that affect the shins. What are they?

Answer 10

-Erythema Nodosum (IBD, sarcoidosis)
-Pyoderma Gangrenosum (idiopathic, IBD)
-Pretibial myxoedema
-?Necrobiosis lipidium diabeticorum

Question 11

Treatment escalation for psoriasis?

Answer 11

1) 4 weeks potent steroid OD and vit D analogue (calpotriol)

2) 8 weeks calpotriol only BD

3) 4 weeks potent steroid BD and continue calpotriol

4) PUVA (psoralen light UV sensitising cream + UVA therapy)

Question 12

What does PUVA increase risk of?

Answer 12

Squamous Cell Cancer only

Question 13

Peeling of epidermal layer under pressure, affecting >30% of skin area, following drug

Answer 13

Toxic Epidermal Necrolysis (TEN)

Question 14

Seborrhaic dermatitis - what is it caused by?
How is it treated?
What are complications?

Answer 14

Caused by fungal infection (malassazia furfur)

Treat with ketoconazole

eyes and ears - blepharitis and otitis externa

Question 15

What is acne rosacea?
How does it present?
What is the first symptom usually?
Difference between acne rosacea and malar rash in SLE?
Treatment escalation in acne rosacea?

Answer 15

Central Red rash affecting face - unknown cause

First flushing
Rash
telangiectasia
papules and pustules can form after

No other symptoms of SLE or systemic symptoms

Brominidine gel for flushing
Topical ivermectin +/- metronidazole or if papules/pustules doxycycline

camouflage cream to help hide

if no help, refer for laser

Question 16

Most common side effect of isotretinoin?

Answer 16

dry skin

Question 17

What nail changes can happen in psoriasis?

Answer 17

onycholysis, loss of nail, subungual hyperkeratosis

Question 18

Are steroids used in acne rosacea?

Answer 18

NO!

Question 19

Depigmentation, precipitated by hot, humid weather?

Answer 19

Pityriasis Versicolour
(fungal infection - malassezia furfur)

Question 20

Which mineral deficiency causes angular cheilosis?

Answer 20

Zinc

Question 21

Causes of hirsutism?

Answer 21

most common is PCOS

• Cushing’s
• Adrenal tumour
• CAH

NB// can be normal with women ageing, as post-menopausal oestrogen level is relatively low to androgen level

Question 22

What do you treat strawberry navi (capillary hemangiomas) with if indicated?

Answer 22

Topical propranolol