Dermatology II

Question 1

What areas of the body can LP affect? (3)

Answer 1

• Oral
• Cutaneous (skin)
• Genital

Question 2

How long are LP lesions normally active for?

Answer 2

Skin lesions active for around 18 months on average

Question 3

Comment on the link between oral and skin LP

Answer 3

• People with skin LP are likely to have oral LP

- People with oral LP aren’t as likely to have skin LP

Question 4

Describe the relationship between friction and LP

Answer 4

Lesions often in areas of increased friction

Question 5

What surfaces are mainly affected by skin LP?

Answer 5

Mainly flexor surfaces of wrists and shins

Question 6

Use the 4 Ps to describe the appearance of skin LP

Answer 6

Purple polygonal pruritic papules

Question 7

What is Vulvovaginal-Gingival Syndrome?

Answer 7

Progressive vulval disease leading to scarring

Question 8

What is Lichenoid Reaction?

Answer 8

• Clinically and histologically similar to LP but aetiology can be identified
• Drug induced
• Dental materials (amalgams)

Question 9

Name some drugs associated with Oral LR (5)

Answer 9

• Beta-blockers
• ACE inhibitors
• Diuretics
• Methyldopa
• NSAIDs

Question 10

Name some materials that can cause oral contact hypersensitive reactions (5)

Answer 10

• Amalgam alloy
• Nickel
• Mercury
• Gold
• bis-GMA

Question 11

What is systemic lupus erythematosus? (3)

Answer 11

• Multi systemic autoimmune disease
• Autoantibodies generated against a variety of autoantigens (such as ANA)
• Involves vascular and connective tissues

Question 12

What is Discoid lupus erythematosus?

Answer 12

Scaly atrophic plaques in sunexposed skin

Question 13

Does systemic lupus erythematosus affect men or women more?

Answer 13

Women 8:1

Question 14

What advice would you give to someone with Discoid lupus erythematosus?

Answer 14

Sun protection is necessary

Question 15

Define vesicle

Answer 15

Small fluid-filled blisters less than 5 mm in diameter

Question 16

Define bulla

Answer 16

Large fluid-filled blisters more than 5 mm in diameter

Question 17

Describe the presentation of Dermatitis herpetiformis

Answer 17

Chronic pruritic papulovesicular rash

Question 18

Describe the clinical presentation of erythema multiforme oral lesions

Answer 18

Bullae or erythematous base break rapidly into irregular ulcers which bleed and form crusts

Question 19

What some causes of erythema multiforme? (3)

Answer 19

• Infections (HSV, Mycoplasma, fungal bacterial)
• Drugs (NSAIDs, barbiturates)
• Systemic (malignancy, pregnancy)

Question 20

What is Pemphigus vulgaris?

Answer 20

Chronic organ-specific autoimmune blistering disease

Question 21

How can you manage oral Pemphigus vulgaris? (4)

Answer 21

• Topical corticosteroids (mouthwashes)
• Systemic corticosteroids
• Steroid sparing agents
• IV immunoglobulins

Question 22

What is Mucous Membrane Pemphigoid?

Answer 22

Rare, autoimmune blistering disease of middle aged or elderly

Question 23

What does Mucous Membrane Pemphigoid normally affect? (4)

Answer 23

• Orogenital
• Conjunctiva
• Larynx
• Oesophagus

Question 24

How can you manage Mucous Membrane Pemphigoid? (6)

Answer 24

• Topical corticosteroids
• Oral prednisolone
• Oral dapsone
• Oral tetracyclines
• Oral azathioprine
• Oral cyclophosphamide