Dermatology

Question 1

Most common cause of oedema in burns victims

Answer 1

Hypoalbuminaemia (due to protein loss)

Can also sometimes be given excess fluids

Question 2

Complications of extensive burns

Answer 2

Haemolysis
Hypoalbuminaemia
Loss of cell membrane integrity
Severe fluid loss
Secondary infections

Question 3

How does pityriasis versicolor present?

Answer 3

Hypopigmented, itchy lesions

Its a fungal infection

Question 4

Management of pityriasis versicolour?

Answer 4

Topical antifungal = ketoconazole shampoo

Question 5

What is isotretinion used for?

Answer 5

Severe acne

Question 6

Side effects of isotretinion

Answer 6

Teratogenic!
Low mood
DRY EYES, SKIN, LIPS AND MOUTH
Hair thinning

Question 7

What is lichen planus?

Answer 7

T cell mediated AI disorder
Inflammation of skin and mucosal keratinocytes
See raised purpley lesions on the body
Itchy
Fine white lines on the surface (Wickham’s striae, may be seen in the mouth)

Question 8

Treatment of lichen planus

Answer 8

Topical steroids

Question 9

What is erythrasma?

Answer 9

Flat rash under armpits and in the groin

Flat and scaly

Question 10

Which antiobiotic can you use for erythrasma

Answer 10

Erythromycin

Question 11

Rubbery, painless, smooth mass on lower back approx 5cm, what is it?

Answer 11

Lipoma

Question 12

What is the cut of for further investigation of a lipoma?

Answer 12

5cm

Question 13

If a lipoma is greater than 5cm what do you worry about?

Answer 13

Liposarcoma

Question 14

Iatrogenic cause of depigmentation in darker skin

Answer 14

Topical clobetasone

Question 15

Treatment of actinic keratoses

Answer 15

Topical fluorouracil cream

Prevention

Question 16

Presentation of actinic keratoses

Answer 16

Sun exposed areas, rough erythematous

Question 17

What is pompholyx eczema?

Answer 17

Subtype of eczema, very itchy rash on the palms and soles
Multiple vesicles or bullar
Usually persists for 4 weeks then resolves

Question 18

Management of pompholyx

Answer 18

Cool compresses
Emollients
Topical steroids

Question 19

What is TEN?

Answer 19

Toxic, epidermal necrolysis

Question 20

TEN has a positive Nikolsky sign, what is this?

Answer 20

Epidermis seperates with mild lateral pressure

Question 21

Management of TEN

Answer 21

ITU supportive care
Intravenous immunoglobulin
Stop casuative drugs

Question 22

What is hidradenitis suppurativa?

Answer 22

Painful skin condition causing abscesses in apocrine sweat glands (armpits and groin)

Question 23

Management of hidradenitis suppurativa

Answer 23

Weight loss
Smoking cessation
Acute flares -> steroids or flucloxacillin

Question 24

What is follicular pyoderma?

Answer 24

Transient, yellow bumps of staph, respond rapidly to antibiotics

Question 25

Treatement of follicular pyoderma

Answer 25

Antibiotics

Question 26

5 P’s of lichen planus

Answer 26

Polyglonal
Pruritic
Planar (flat topped)
Papular 
Purple

Question 27

What is Pemphigus vulgaris

Answer 27

Affects very surface of skin, so they erode very very easily = flaccid blisters

Often mucosal involvement

VulgariS = surface

Question 28

What is Bullous pemphigoid

Answer 28

Autoimmune skin condition against BP180 and BP230

Deeper bit of skin affected, see fluid filled blisters
Tense blisters

NO MUCOSAL INVOLVEMENT

Skin biopsy shows IgG and C3 at the dermoepidermal junction

Question 29

Treatment of bullous pemphigoid

Answer 29

Oral corticosteroids

Question 30

How might rosacea present?

Answer 30

Face rash
Slightly pustular
Often flushing 
Telangiectasia is common 
Can have eyelid involvement (red)
Sunlight may exacerbate symptoms

Question 31

Management of rosacea

Answer 31

Topical metronidazole for mild cases

Topical brumonidine gel for flushing but limited other Sx

More severe -> systemic antibiotics = oxytetracycline

Daily aplication of sunscreen

Question 32

Management of vitiligo

Answer 32

Sun block
Topical tacolimus
Phototherapy
Topical corticosteroids! (May reverse if applied early)

Vitiligo is autoimmune