Dermatology

Question 1

Seborrhoeic Keratoses

Answer 1

• large variation in colour from flesh to light-brown to black
• have a ‘stuck-on’ appearance
• keratotic plugs may be seen on the surface

Question 2

Rash with “fir tree” appearance

Answer 2

Pityriasis rosea

Question 3

What causes Erythrasma?

Answer 3

Corynebacterium minutissimum

Question 4

Management of Erythrasma?

Answer 4

Erythromycin

Question 5

Exclamation mark hairs

Answer 5

Alopecia

Question 6

Margins for excision of SCC

Answer 6

Surgical excision with 4mm margins if lesion <20mm in diameter. If tumour >20mm then margins should be 6mm.

Question 7

Differentiating Lichen planus vs. sclerosus

Answer 7

planus: purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham’s striae over surface. Oral involvement common
sclerosus: itchy white spots typically seen on the vulva of elderly women

Question 8

Features of Guttate psoriasis

Answer 8

Young - children and adolescents
Tear drop lesions on trunks and limbs
Streptococcal infection in the last month
Resolves on its own within 3 months

Question 9

What may dermatomyositis be associated with?

Answer 9

Internal malignancy

Question 10

Management of Acne Roseacea

Answer 10

mild/moderate: topical metronidazole

severe/resistant: oral tetracycline e.g. Doxycycline

Question 11

Diagnosis of Cellulitis

Answer 11

Clinical

- blood and cultures if septic

Question 12

Classification of patients with Cellulitis

Answer 12

Eron
1 - no sytemic toxicity and no uncontrolled co-morbidities
2 - systemically unwell or has an uncontrolled co-morbidity
3 - significant systemic upset or very unstable co-morbidity that may interfere with treatment
4 - Sepsis or life-threatening infection

Question 13

Indications for admission with cellulitis for IV antibiotics

Answer 13

• Eron Class III or IV
• Deteriorating cellulitis
• Under 1 yo
• Frail
• Immunocomprimised
• Lymphoedema
• Facial cellulitis (unless mild)
• Periorbital cellultis

Question 14

Management of Cellulitis

Answer 14

Flucloxacillin (Doxycycline if allergic)
Clarithromycin in Pregnancy

If severe - co-amoxiclav, cefuroxime, clindamycin or ceftriaxone.

Question 15

Difference between periorbital and orbital cellulitis

Answer 15

Periorbital Cellulitis

• Preseptal
• Less serious (may develop into orbital cellulitis)
• Ptosis and eye swelling

Orbital Cellulitis

• Postseptal
• Medical emergency
• Reduced visual acuity
• Proptosis
• Pain with eye movements

Question 16

Investigating orbital cellulitis

Answer 16

CT with contrast

Question 17

Mean age of orbital cellulitis hospitalisation

Answer 17

7-12 year olds

Question 18

Management of periorbital cellulitis

Answer 18

Co-amoxiclav

Question 19

Difference between presentation of Roseola Infantum and Chicken Pox

Answer 19

Roseola Infantum - high grade fever which resolves and is then followed by a non-itchy rash that starts on the trunk and then spreads to the limbs

Chicken pox - itchy red papular rash which then becomes vesicular in nature (may occur anywhere first and then spread)