Dermatology Surgery incorrects

Question 1

risk factors for pyoderma gangrenosum? (begins with small papule or pustle -> to painful ulcer with purulent violaceous base that is RAPIDLY expanding -> key sign. )

investigation

treatment?

Answer 1

rhuematoid arthritis!!!
inflammatory bowel disease eg chrons!!!
malignancy

skin biopsy!! -> neutrophil predominant mixed cellular infiltrate

corticosteroids

Question 2

what type of ulcer does pseudomonas cause?

Answer 2

ecthyma gangrenosum
necrotic ulcer
fever
focal pain less present
occur in profound neutropenia and bacteremia

Question 3

hidradinitis supporative treatment?

Answer 3

topical or sytemic antibiotics

Question 4

woman post-breast cancer treatment. had radiotherapy. now has lymphedema (risk factors)

now develops red plaques and purple papules on arm 4 years later

most likely diagnosis?

first step in management?

Answer 4

(secondary) angiosarcoma - malignant endothelial tumour

lesion biopsy

Question 5

erythema nodosum presentation?

Answer 5

red pathes/spots on legs

do NOT ULCERATE

Question 6

skin malignancy post renal transplant is most likely?

Answer 6

renal cell carcinoma

Question 7

investigation for BCC?

Management of Basal cell carcinoma 1.5cm on face?

Answer 7

excisional biopsy is always first investigation for skin cancer. scc you can do punch, shave or excisional biopsy

high risk eg lesions on the face!!, hands and feet especially >/= 1 cm = MOHS Micrographic surgery!!!

lesions somehwere else/non cosmetically sensitive = standard excision with 4mm margins. (1cm margins would be used for a melanoma instead)

topical 5 fluorouracil = < 1cm low risk lesions

Question 8

5cm brown lesion, smooth border with an eccentric nodule

multiple other scattered brown lesions

next step in management?

Answer 8

Excisional biospy!!

mole may present a melanoma if it is very different from other moles (ugly duckling sign), itches or bleeds, or develops nodularity

Question 9

scaly papule with central ulcer on lower lip. what is the most likely type of skin cancer?

Answer 9

squamous cell carcinoma

associated chronic venous ulcers, burns/chronic scarring, immunosuprression, sun exposure

Question 10

how does a dermatofibroma present?

Answer 10

firm pigmented nodule often on lower extremities

central area dimples when pinched

Question 10

arterial ulcers occur at tips of body eg toes

Question 11

how do lipomas present?

Answer 11

SOFT to rubbery,irregular, do not regress!!

Question 12

how does an epidermal inclusion cyst present

Answer 12

FIRM movable cyst or nodule
usually resolves spontaneously