Dermatology

Question 0

Additional places to check for plaques in Psoriasis

Answer 0

Ears
Umbilicus
Scalp

(Nails: pitting, onycholysis, ridges, discolouration, subungual hyper keratosis)

Question 1

Acne management

Mild

Moderate

Severe

Answer 1

1. Topical BENZOYL PEROXIDE; Abx (clindamycin); salicylate/Azelaic acid
   (Just comedones)
2. Doxycycline (systemic and topical); Benzoyl Peroxide
   (Inflammatory lesions on face, chest and back)
3. Isoretinoin (monitor lipids, can increase), co-cyprindiol (ie. dianette if woman)
   (Resistant to treatments, cysts and nodule)

Question 2

Treatments of psoriasis

Answer 2

“STAVED”

Steroids (topical)
Tar
Aspirin
Vitamin D (calcipotriol - safer than dithranol and does not stain skin)
EMOLLIENTS
DITHRANOL (stains skin purple, can burn normal skin)

Systemic:
Methotrexate + cyclosporin
Retinoids

Phototherapy:
UVB
PUVA (psoralen & UVA)

Question 3

Complications of psoriasis

Answer 3

Arthropathy (5 types)
DIPJ involvement (OA-like)
Rheumatoid-like
Mutilans
Sacroiliitis (like Ank spond)

Erythroderma

Question 4

Conditions with Koebners phenomenon

Answer 4

Lichen planus
Viral warts
Psoriasis 
Vitiligo
Sarcoid 

“SS LL V”

Question 5

Eczema management

Answer 5

Avoid precipitants

Emollients
Topical steroids
Antihistamine (for pruritis)
Abx for secondary infections
UV light therapy

Question 6

1. Stigmata of venous leg disease
2. Features of venous leg ulcer
3. Other places/stuff to look for

Answer 6

1. Varicose veins and stripping
Oedema
Atrophie Blanche
Liopodermatosclerosis
Eczema

2. Painless
   Not well-demarcated
   Gaiter distribution
3. Abdominal and pelvic masses (?stuff obstructing venous blood flow)

Question 7

Arterial ulcer features

2. Other stuff/places to look for

Answer 7

Painful
Distal extremities and pressure points affected

Trophic changes:
Hairless, paper thin shiny skin
Cold limb with poor cap refill
Absent distal pulses

2. CVS exam, look for AF and murmurs

Question 8

Neuropathic ulcer features

Answer 8

Painless
Pressure areas affected (eg. Under the metatarsal regions)
Peripheral neuropathy

Question 9

Management of venous ulcers

Answer 9

Remove exudates and regular cleaning
Dressings - high-pressure
Surgery
Treat surrounding eczema with emollients etc.