Dermatology

Question 1

Which enzyme is affected in each of the following porphyrias?

• Erythropoietic
• Porphyria cutanea tarda 1
• Acute intermittent porphyria

Answer 1

Erythropoietic - ferrochelatase
Porphyria cutanea tarda 1 - uroporphyrinogen decarboxylase
Acute intermittent porphyria - porphobilinogen

Question 2

What is chronic actinic dermatitis?

Answer 2

Photosensitive eczema

Question 3

What is seborrheic dermatitis?

Answer 3

Red, scaly rash affecting scalp, eyebrows, nasolabial folds, cheeks, flexures
Caused by atopic eczema
Also called cradle cap

Question 4

“Crazy paving” eczema = ?

Answer 4

Steatotic eczema - fissures and cracks on skin
Usually occurs on shins of elderly patients
More common in winter

Question 5

What is pompholyx eczema?

Answer 5

Type of eczema affecting hands and feet

Watery blisters

Question 6

What are the three stages of wound healing?

Answer 6

1. Inflammation - platelets, inflammatory mediators, leukocytes
2. Proliferation + tissue remodelling - new tissue is formed
3. Tissue remodelling - new tissue is converted to mature scar tissue

Question 7

“Target” skin rash = ?

Associated with?

Answer 7

Erythema multiformae

Caused by lots of things including recent infection, drugs

Question 8

Large painless ulcer on penis after unprotected sex = ?

Answer 8

Syphilis

Question 9

Aside from sebaceus glands, which other glands attach to the hair follicle?

Answer 9

Apocrine

These are scent glands found in the nipple, groin, axilla

Question 10

Where are eccrine glands in higher concentration?

Answer 10

Sole of foot, palm of hand

Question 11

Which antibodies are associated with immunobullous disorders?

Answer 11

IgG

Question 12

Herald patch

Answer 12

Pityriasis rosaea

Question 13

Fleshy moist red lesion on finger

Answer 13

Pyogenic granuloma

Question 14

Who tends to get bullous pemphigoid?

Answer 14

Elderly

Often preceded by itching

Question 15

Jewish person with skin problem

Answer 15

Pemphigus vulgaris

Question 16

What else on the body can pemphigus affect?

Answer 16

Oral mucosa

Question 17

What is seen on biopsy of pemphigus?

Answer 17

Acantholysis

Question 18

Treatment of pemphigus and pemphigoid?

Answer 18

Prednisolone

Question 19

Definition of Breslow thickness?

Answer 19

Depth from granular layer to deepest point of invasion

Question 20

What does guttate psoriasis usually follow?

Answer 20

Streptococcal illness

Question 21

What do flexoral psoriasis plaques look like?

Where are they found?

Answer 21

Erythematous but not scaly

Sumamammary, axillary, anogenital, umbilical

Question 22

Pearlescent nodule in a child = ?

Answer 22

Molluscum contagiosum

Question 23

Which HPV are associated with

• genital warts
• cervical cancer

Answer 23

Genital warts 6 + 11

Cervical cancer 16 + 18

Question 24

Erythema infectiosum is caused by which virus?

Aka

Answer 24

Parovirus B19

Slapped cheek disease

Question 25

Erythema migrans = ?

Answer 25

Lyme disease | Treat with doxycycline

Question 26

Which organism causes Syphilis?

Answer 26

T pallidum

Question 27

Mucous membrane "snail track" ulcers

Answer 27

Secondary syphilis

Question 28

5 year survival of Breslow thickness >4 mm?

Answer 28

50 %

Question 29

Investigation of porphyria cutanea tarda?

Answer 29

Woods lamp

Question 30

"Stuck on" appearance

Answer 30

Basal cell papilloma (seborhaeic keratoses)

Question 31

Picket fence pearly border

Answer 31

Basal cell carcinoma

Question 32

Give three causes of erythema nodosum

Answer 32

Sarcoidosis IBD TB

Question 33

“Erythematous Bullseye lesion”

Answer 33

(Erythema migrans) - Lyme disease

Question 34

Cauliflower appearance

Answer 34

Plantar warts

Question 35

Who gets kaposi sarcoma?

Answer 35

HIV, immunosuppressed (transplant)

Question 36

Fish scale skin

Answer 36

Ichthyosis

Question 37

Target lesion

Answer 37

Erythema multiforme | Most commonly caused by drugs