Dermatology

Question 1

What is acne?

Answer 1

Disorder of pilosebaceous apparatus
Excess sebum secretion
Caused by hormones
Obstruction of the pilosebaceous duct
Bacteria
Drugs 
Peaks in adolescence
Comedones, papules, pustules, nodules, cysts, scars

Question 2

Acne treatment

Answer 2

Local abrasives
Topical antibiotics
Topical vitamin A analogues 
Topical antibiotics
Isotretinoin

Question 3

What is rosacea?

Answer 3

Affects the face of adults
Flushing, erythema, telangiectasia (dilation of capillaries), inflamed papules, pustules
May be associated conjuctivitis, blepharitis (inflammation of the eyelid)

Question 4

What can rosacea be triggered by?

Answer 4

Spicy foods
Alcohol
Stress
Temperature change
Sunlight

Question 5

Rosacea treatment

Answer 5

Avoid triggering factors
Antibiotics (topical +/ systemic)
Cosmetic camouflage
Laser
Isotretinoin (Roaccutane)
AVOID topical steroids

Question 6

What is impetigo caused by?

Answer 6

Staphylococci / streptococci

Question 7

Signs and symptoms of impetigo

Answer 7

Contagious
Exudate and yellow crusting
May blister
May trigger glomerulonephritis (damage to filters in kidney)
Treated with antibiotics

Question 8

What is folliculitis?

Answer 8

Superficial infection of the hair follicle, usually caused by S. Aureus (Possibly nasal Staph carrier)

Question 9

Signs of folliculitis

Answer 9

Papules and pustules associated with hair follicles surrounded by 1-2mm of erythema

Question 10

What is a furuncle?

Answer 10

Boil
Small perifollicular abscess
Hair follicle is destoyed

Question 11

What are furuncles caused by?

Answer 11

Staphylococcus Aureus on hair bearing sites

Question 12

Signs and symptoms of furuncle

Answer 12

Tender and inflamed

e.g. Stye - furuncle involving sebaceous gland of eyelid margin

Question 13

What is a carbuncle?

Answer 13

Larger furuncle (3-10cm nodule)

Question 14

What is Erysipelas?

Answer 14

A form of cellulitis, Strep

Question 15

Signs and symptoms of Erysipelas

Answer 15

Spreading red edge, sharp edge
On face or extremity
Discomfort, fever, malaise
Treated with systemic antibiotic

Question 16

What virus causes viral warts?

Answer 16

Human Papilloma virus

Question 17

What is Molluscum Contagiosum caused by?

Answer 17

DNA pox virus

Question 18

What type of Herpes Simplex usually causes facial lesions?

Answer 18

H. Simplex type 1

Question 19

What signs and symptoms present in a primary eruption in children?

Answer 19

Acute gingivo-stomatitis, malaise, fever

Question 20

How can Herpes Simplex recurrences be triggered?

Answer 20

UVL
Menstruation
Stress

Question 21

What can Herpes Simplex be treated with?

Answer 21

Aciclovir (Zovirax)
Valciclovir
Prophylactic antivirals

Question 22

What is a Herpes Zoster?

Answer 22

Reactivation of chicken pox virus in dorsal root ganglion

Question 23

Who have increased incidence of Herpes Zoster?

Answer 23

The elderly

Immunosuppressed

Question 24

What virus causes hand foot and mouth?

Answer 24

Coxsackie A virus

Question 25

How does hand foot an mouth present?

Answer 25

Vesicles with red halo on hands and feet | Erosions in the mouth

Question 26

What does Dermataphyte cause?

Answer 26

Ringworm and tinea

Question 27

What can it's appearance be masked by?

Answer 27

Topical steroids

Question 28

How is it treated?

Answer 28

Topical +/ systemic antifungals

Question 29

How may eczema present? Acute and chronic

Answer 29

Acute - Red, swollen, papules and vesicles | Chronic - Scaly, pigmented, thickened, accentuated skin markings

Question 30

Endogenous Eczema

Answer 30

Atopic eczema Varicose eczema Seborrhoeic eczema

Question 31

Exogenous eczema

Answer 31

Allergic contacts dermatitis Irritant contact dermatitis Photo contact dermatitis

Question 32

Treatment of eczema

Answer 32

``` Avoid: irritants moisturisers steroids UVL (immunosuppressives) ```

Question 33

What is psoriasis?

Answer 33

Chronic inflammatory disease of the skin

Question 34

What are the different clinical patterns of psoriasis?

Answer 34

Plaque (white build up of dead skin) Guttate (starts in childhood / young adulthood; small, red, separte spots) Flexural (localised to skin folds) Pustular (appearance of pus spots surrounded by red) Erythrodermic (often affects most of bod; rare)

Question 35

What areas are commonly affected by psoriasis?

Answer 35

Scalp and hairline

Question 36

What signs may display in nails?

Answer 36

Pitting Onycholysis (painless detachment of nail) Subungual hyperkeratosis (excessive proliferation of the nail bed)

Question 37

What is used to treat psoriasis?

Answer 37

``` Tar Dithranol Vitamin D creams Phototherapy Systemic immunosuppressives ```

Question 38

What is lichen planus?

Answer 38

Itchy, violet colour flat-topped papules on wrists and legs White streaky pattern on surface of papule White asyptomatic lacy reticulate streaks in mouth May be genital involvement

Question 39

What is a Bullous Pemphigoid?

Answer 39

Autoimmune disease | Sub-epidermal large tense blisters

Question 40

What is a Cicatrical Pemphigoid?

Answer 40

Blisters and ulcers affecting mucous membranes | Ig and C3 bind to basement membrane zone

Question 41

What is used to treat it?

Answer 41

Steroids +/- immunospressives

Question 42

What is Pemphigus?

Answer 42

A severe life threatening auto-immune disease

Question 43

Pemphigus vulgaris

Answer 43

IgG Ab bind to intercellular cement | Flaccid blisters, erosions

Question 44

What can trigger Erythema multiforme?

Answer 44

``` Herpes simplex Drugs Cancers Radiotherapy Connective tissue diseases ```

Question 45

Classic presentation of erythema multiforme

Answer 45

Target lesion Bullae may form Mucosal involvement common

Question 46

What happens with severe mucosal involvement?

Answer 46

Stevens-Johnson - acute onset Systemic disturbance Risk of renal failure and bronchopneumonia

Question 47

Reaction patterns caused by drugs?

Answer 47

``` Toxic erythema Urticaria Purpura Erythema multiforme Acne Lichenoid rash Dermatitis Bullous disorders Photosensitivity Hair loss Fixed drug eruption ```

Question 48

Which group of patients may be at increased risk of Actinic keratoses and Bowen's disease?

Answer 48

Immunosuppressed

Question 49

What is Actinic Keratoses?

Answer 49

Hyperkeratonic areas on sun-exposed skin

Question 50

Where is Bowen's disease - intra-epidermal squamous cell cancer most common?

Answer 50

On lower legs in elderly females