Dermatology

Question 1

Define lesion

Answer 1

Single area of altered skin

Question 2

Telangiectasia

Answer 2

Prominent cutaneous blood vessels

Question 3

Macular

Answer 3

Flat <5-10mm

Question 4

Papular

Answer 4

Raised <5-10mm

Question 5

Patch

Answer 5

Flat >5-10mm

Question 6

Plaque

Answer 6

Raised, flat topped >5-10mm

Question 7

Nodule

Answer 7

Raised/elevated >5-10mm
Firm
Arises from dermis or subcutaneous tissue

Question 8

Treat seborrhoeic keratosis/senile warts

Answer 8

Leave it
If symptomatic/traumatised/diagnostic uncertainty…
- Cryotherapy
- Biopsied

Question 9

Vesicular

Answer 9

Fluid filled <5mm

Question 10

Bullae

Answer 10

Fluid filled >5mm

Question 11

Pustule

Answer 11

Pus filled lesion <5mm

Question 12

Abscess

Answer 12

Pus lesions >5mm

Question 13

Other words for scaly… (and some conditions)

Answer 13

Hyperkeratosis

• psoriasis

Question 14

Crust

Answer 14

Dry exudate/blood

Question 15

Fungating

Answer 15

Large malignant tumour erupting like a fungus

Question 16

Treating acitinic/solar kératoses

Answer 16

Emollients
Sunscreen advice (could be pre-malignant)
5-FLUOROURACIL (5-FU)
Cryotherapy

** hyperkeratosis!

Question 17

Lichenification

Answer 17

Lines/grooves in thickened skin

Question 18

Ulcers

Answer 18

Full thickness Loss of epidermal layer

Question 19

Granulation tissue

Answer 19

Connective tissue/blood vessels form on wound surface during healing

Question 20

Types of BCC

Answer 20

Nodular
Cystic
Multicentric

• Superficial - can look a bit like psoriasis or Bowen’s disease

Question 21

Treating BCC

Answer 21

Excision

Radiotherapy (older patients)

Question 22

Less well demarcated lesion on the nose, atrophic centre, waxy appearance

Answer 22

Morphoeic BCC

Harder to treat

Question 23

ABCDE for describing moles

Answer 23

Asymmetry
Irregular Border
Colours 2+
Diameter (>6mm)
Evolving

Question 24

Major 2pts for Moles

Minor 1pt for Moles

Answer 24

Major

• change in size
• irregular colour
• irregular shape

Minor

• 7mm diameter
• inflammation
• oozing
• itching

Question 25

Hyperkeratosis, Nodular lesions | Common on the lips in smokers

Answer 25

SCC

Question 26

Treating SCC

Answer 26

Excision with 4mm margins | Radiotherapy (older patient)

Question 27

Raised lesions

Answer 27

Papule Nodule Plaque

Question 28

Flat lesions

Answer 28

Macular | Patch

Question 29

Fluid filled lesions

Answer 29

Vesicle | Bulla

Question 30

Well demarcated, ulcerated, nodular edge, overlying keratosis on the race

Answer 30

Ulcerating SCC

Question 31

Erythematous plaque with silver scale, well demarcated, symmetrical lesion Differentials?

Answer 31

Cutaneous fungal infection Psoriasis Discoid eczema (v pruritic) (Most likely psoriasis)

Question 32

Nail changes in psoriasis

Answer 32

``` Subungual Hyperkeratosis parakeratosis (leukonychia) Pitting Onycholysis (nail and nail bed separate) Oil drop ```

Question 33

Treating Psoriasis

Answer 33

Weight loss, Smoking cessation, Reduce alcohol intake Emollient Topical steroids (dovobet = vit D analogue and steroid) Phototherapy Systemic treatments: methotrexate, biologics

Question 34

Complications of psoriasis

Answer 34

Increased risk CVS disease and thromboembolism Joint aches

Question 35

Vesicular eruption overlying eczema, golden crusts

Answer 35

Herpes simplex virus and staph bacterial colonisation after eczema

Question 36

What do golden crusts suggest

Answer 36

BACTERIAL INFECTION