Dermatology

Question 1

What rash is common in post-mature infants?

Answer 1

Erthema toxicum

Question 2

Which infants are most at risk of erythema toxicum?

Answer 2

Those that are post-mature

Question 3

What does an erythema toxicum rash look like?

Answer 3

White pinpoint papules at the centre of an erythematous base

Question 4

What tend to be the causative organisms of hand, foot and mouth disease?

Answer 4

1. Coxsackie A16

2. Enterovirus 71

Question 5

How is hand, foot and mouth disease managed?

Answer 5

1. Push fluids - keep hydrated
2. Analgesia
3. No need for school exclusion
4. Reassurance that not related to disease in cattle

Question 6

What is the causative organism of roseola infantum?

Answer 6

HHV6

Question 7

What comes first in roseola infantum - fever or rash?

Answer 7

FEVER (always first, THEN rash)

Question 8

What are the complications of roseola infantum?

Answer 8

Aseptic meningitis

Hepatitis

Question 9

How is chicken pox spread?

Answer 9

Via the respiratory route

Question 10

What is the incubation of chicken pox?

Answer 10

10-21 days

Question 11

When is the infectious period with chicken pox?

Answer 11

4 days prior to, and 5 days after the rash first appears

Question 12

When do you keep a child off school until with chicken pox?

Answer 12

Until the vesicles have crusted over

Question 13

What do you give exposed immunocompromised patients and newborns for prophylaxis?

Answer 13

VZIG (1 dose)

Question 14

What do you give immunocompromised patients and newborns if chicken pox has already developed?

Answer 14

IV acyclovir

Question 15

What are the complications of chicken pox?

Answer 15

Secondary bacterial infection of lesions
RARE - pneumonia; encephalitis; disseminated hemorrhagic chicken pox
V RARE - arthritis/nephritis/pancreatitis

Question 16

What is the causative organism of scarlet fever?

Answer 16

Group A strep

Question 17

In which condition does the rash feel like ‘sandpaper’?

Answer 17

Scarlet fever

Question 18

What is strawberry tongue, and in which condition do you see it?

Answer 18

= a white coat on the tongue through which red papillae may be seen
Seen in scarlet fever

Question 19

What is the management of scarlet fever?

Answer 19

Oral penicillin V (azithromycin if penicillin allergic)

Question 20

When can children return to school with scarlet fever?

Answer 20

24 hours after starting antibiotics

Question 21

What are the complications of scarlet fever?

Answer 21

1. Otitis media
2. Rheumatic fever
3. Acute glomerulonephritis

Question 22

What is the causative organism in measles?

Answer 22

RNA paramyxovirus

Question 23

Where does the rash start in measles?

Answer 23

Behind the ears

Question 24

What are Koplik spots, and when do they come on?

Answer 24

‘Grains of salt’ in the buccal mucosa, tend to come on before the rash

Question 25

How is measles Dx?

Answer 25

IgM antibodies (a few days post-rash onset)

Question 26

What very rare complication of measles might occur 5-10 years post-illness?

Answer 26

Subacute sclerosing pan-encephalitis

Question 27

What is scabies an infestation of?

Answer 27

Sarcoptes scabei mite

Question 28

When is itching in scabies worse?

Answer 28

In the warm and at night

Question 29

What is the treatment for scabies?

Answer 29

Permethrin 5% all over body, washed off after 8-12 hours, re-application 1 week later. All members of household treated

Question 30

How does SSSS differ from TENS?

Answer 30

No mucosal involvement

Question 31

What is seen under the microscope in SSSS vs. TENS?

Answer 31

``` SSSS = characteristic horny layer TENS = full-thickness necrotic epidermis ```

Question 32

How should SSSS be managed?

Answer 32

Flucloxacillin

Question 33

What are the 3 types of neonatal herpes simplex?

Answer 33

1. SEM herpes - skin, eyes, mouth 2. DIS herpes - disseminated herpes, affecting internal organs, esp. the liver 3. CNS herpes

Question 34

What tend to be the causative organisms in impetigo?

Answer 34

1. S.aureus | 2. Streptococcus pyogenes

Question 35

How does SJS and TENS differ?

Answer 35

``` SJS = <10% BSA TENS = >30% BSA ```

Question 36

How is SJS Dx?

Answer 36

Clinically - severe mucosal ulceration involving at least 2 mucosal surfaces ( e..g lip, oral cavity, nasal, conjunctiva, urethra, vagina, GI tract or resp tract)

Question 37

What drugs can cause SJS/TENS?

Answer 37

1. Sulphonamides 2. NSAIDs 3. Antibiotics 4. AEDs 5. Barbiturates 6. Allopurinol 7. Tetracyclines

Question 38

What infections can cause SJS/TENS?

Answer 38

1. AIDS 2. HSV 3. EBV 4. Influenza 5. Typhoid 6. Group A strep 7. Dermatophyte

Question 39

If it is a drug cause, when do SJS/TENS tend to present?

Answer 39

2-3 weeks after starting said drug (i.e. a delayed reaction)

Question 40

What proportion of children with atopic eczema have Sx resolution by 12?

Answer 40

50%

Question 41

What proportion of children with atopic eczema have Sx resolution by 16?

Answer 41

75%

Question 42

What proportion of children with atopic eczema will go on to develop asthma?

Answer 42

1/3rd

Question 43

What tends to cause guttate psoriasis?

Answer 43

Strep/viral sore throat, or ear infection

Question 44

Over what period does guttate psoriasis tend to resolve?

Answer 44

Over 3-4 months

Question 45

What is the mild topical steroid?

Answer 45

Hydrocortisone

Question 46

What are the moderate topical steroids?

Answer 46

Eumovate | Modrasone

Question 47

What are the potent topical steroids?

Answer 47

Betnovate Synalar Elocon

Question 48

What is the very potent topical steroid?

Answer 48

Dermovate