dermatology

Question 1

what does acne vulgaris produce?

Answer 1

Produces either open comedones (blackheads) or closed comedones (white heads), inflammatory papules and pustules

Question 2

how can acne vulgaris be treated?

Answer 2

o Acne soaps
o Topical benzoyl peroxide
o Topical erythromycin
o topical retinoids – tretinoin
o 2nd line – trimethoprim
o 3rd line- oral retinoids – vitamin A analogues

Question 3

what is eczema?

Answer 3

Superficial skin inflammation with vesicles, redness, oedema, oozing, scaling and pruritus

Question 4

what can cause atopic eczema?

Answer 4

• hereditary
• abnormal epithelial barrier function
• loss-of-function mutations in filaggrin
• high serum IgE

Question 5

what are the clinical features of atomic eczema?

Answer 5

• Itchy, erythematous scaly patches
• In flexures – elbows, ankles, knees, around neck
• Excoriations (scratch marks) and skin thickening (lichenification)
• Hyper- or hypo- pigmentation

Question 6

how is atopic eczema managed?

Answer 6

• avoid irritants
• emollients
• hydrocortisone

Question 7

what can contact dermatitis be caused by?

Answer 7

chemical irritant or a type IV hypersensitivity reaction

Question 8

how does contact dermatitis present clinically?

Answer 8

Rash with clear demarcation/odd-shaped areas

Question 9

what is the aetiology of psoriasis?

Answer 9

• polygenic

- environmental triggers- group A strep, lithium, UV light

Question 10

how does chronic plaque psoriasis present clinically?

Answer 10

salmon-pink silvery scaling lesions on extensor surfaces of limbs, with scalp involvement

Question 11

how is psoriasis managed ?

Answer 11

• emolients
• topical vitamin D analogues- calcipotriol
• salicyclic acid

Question 12

how are skin ulcers managed?

Answer 12

• treat causes
• nutrition
• 4 layer compression bandage

Question 13

what are some risk factors of cellulitis?

Answer 13

lymphoedema
venous insufficiency
leg oedema
obesity

Question 14

what are some clinical features of cellulitis?

Answer 14

erythema, swelling, warmth, tenderness, low-grade fever

Question 15

how is cellulitis treated?

Answer 15

phenoxymethylpenicillin and flucloxacillin

Question 16

what is necrotising fasciitis and what is it caused by?

Answer 16

• rapidly progressing infection of deep fascia
• necrosis of subcutaneous tissue
• group A beta-haemolytic strep

Question 17

how is a basal cell carcinoma treated?

Answer 17

• surgical incision

- radiotherapy, cryotherapy, photodynamic therapy

Question 18

what is the ABCDE criteria for diagnosing a malignant melanoma?

Answer 18

Asymmetry of mole
Border irregularity 
Colour variation
Diameter
Elevation

Question 19

summarise the Glasgow 7 point checklist for a malignant melanoma

Answer 19

major criteria- change in shape/ size/ colour

minor- diameter>6mm, inflammation, oozing/ bleeding, mild itch

Question 20

what are the 4 clinical types of malignant melanoma?

Answer 20

• lentigo malignant melanoma
• superficial spreading malignant melanoma
• nodule malignant melanoma
• acral lentignous malignancy melanomas

Question 21

what are some features of acne vulgaris?

Answer 21

• increased sebum production by sebaceous glands
• blockage of pilosebaceous units
• follicular epidermal hyperproliferation
• scarring
• hyperpigmentation

Question 22

what group of organisms can cause cellulitis?

Answer 22

streptococcus

Question 23

how is necrotizing fasciitis treated?

Answer 23

• radial debridement

- IV benzylpenicillin and clindamycin

Question 24

what are some types of skin ulcer?

Answer 24

• venous
• arterial- large/ small
• neuropathic
• vasculitic
• infective- TB/ syphilis
• traumatic
• drug-induced

Question 25

how does flexural psoriasis present clinically?

Answer 25

red glazed, non-scaly plaques in flexures

Question 26

how does guttate/ raindrop psoriasis present clinically?

Answer 26

explosive eruption of small circular/oval plaques appear on trunk

Question 27

how does Erythrodermic and pustular psoriasis present clinically?

Answer 27

widespread intense inflammation of skin, with malaise, pyrexia and circulatory problems