Dermatology

Question 1

Eczema can get infected by….

• bacterial e.g.
• viral e.g.

Answer 1

• staphylococcal infections

- eczema herpeticum (herpes)

Question 2

Psoriasis usually presents as…

Answer 2

…symmetrical focal, well demarcated, inflamed plaques covered with silvery scales. Mostly on extensor surfaces

Question 3

4 Treatments of psoriasis

Answer 3

• Emmolients
• Topical Steroids
• Vit D analogues
• UV Therapy
• Systemics e.g. methotrexate, ciclosporin

Question 4

Psoriasis pathophysiology

Answer 4

• only 6 day skin cell turnover
• so disordered maturation of keratinocytes
• hyperproliferation thickens the epidermis

Question 5

Acne is due to over activity where?

What causes it?

Answer 5

Pilo-subaceous units of skin due to hormones.

Hyperproliferation of follicular epidermis. Follicules get infected with propionibacterium acnes

Question 6

Acne Treatments:

Answer 6

• topical retinoids e.g. adapalere
• topical antibiotics e.g. dalacin-T
• O.C.Pill e.g. dianette

In unresponsive severe cases, dermatologist may give the systemic retinoid - Isotretinoin

Question 7

A “gold crust” characterises which common skin infection? Which antibiotic treats it?

Answer 7

Imetigo (caused by staphylococcus aureus)

Oral Flucloxacillin

Question 8

Tinea/ringworm is a v itchy infection caused by..?

Treatment?

Answer 8

The fungus, Trichophyton rubrum

Treat with antifungal-azole, allylamine

Question 9

What is AK-Actinic Keratinosis?

Answer 9

Common sun-induced hyperkeratotic lesion.

Potential for malignancy to SCC.

Question 10

What is Bowen’s disease?

Answer 10

A pre-cancerous lesion. It is a SSC in situ, has well defined plaques.

Question 11

What is Sqamous Cell Carcinoma?

Give 3 examples of how Sqamous Cell Carcinoma may arise.

Answer 11

Invasion of atypical squamous cells into the dermis.

Cumulative sun exposure
De novo
AK
Bowens

Question 12

What is a Basal Cell Carcinoma/Rodent Ulcer?

Answer 12

Slow growing malignancy, shiny nodule with a rolled edge
Arises on its own
Tends to remain localised

Question 13

ABCDE rule for suspicious pigmented lesions is:

Answer 13

A-symmetry
B-order Irregularity
C-olour Variation
D-iameter
E-xtra features

Question 14

Melanoma histology

What is Breslow Thickness?

Answer 14

Atypical melanocytes that invade into the dermis and subcutaneous fat, depth is a prognostic indicatior.
Breslows Thickness=Depth of Invasion