Extra Derm

Question 1

pityriasis (tinea) versicolor - describe lesions

• who
• where

Answer 1

pale, velvety hypopigmented macule which is non scaly. There may be scaling on scraping of the lesions

seen in Britain after sun tanning abroad, causes depigmentation of tanned skin and increased pigmentation of untanned skin

commonly occurs on chest, back and shoulders

Question 2

treatment of pityriasis (tinea) versicolor

Answer 2

antifungal agents

eg ketoconazole cream

or oral terbinafine

Question 3

what is erythema nodosum associated with

Answer 3

sarcoidosis, TB , IBD

OCP, penicillin, sulphonamide

Question 4

describe erythema nodosum

Answer 4

erythematous raised nodules on anterior shins

Question 5

what is dermatitis herpetiformis associated with

Answer 5

coeliac disease - look for symptoms of GI disturbance and malabsorption in history

DH and coeliac are due to intolerance of gliadin fraction of gluten - triggers production of IgA antibodies and an autoimmune process that targets the skin and gut

Question 6

describe dermatitis herpetiformis lesions

Answer 6

symmetrical and typically affect the extensor surfaces of elbows, knees upper back and buttocks

intensely itchy

Question 7

which Ab are present in dermatitis herpetiformis

Answer 7

anti-endomysial

Question 8

what does skin biopsy show in dermatitis herpetiformis

Answer 8

IgA deposits along dermal papillae

Question 9

treatment of dermatitis herpetiformis

Answer 9

gluten free diet and Dapsone

Question 10

asteatotic eczema

Answer 10

common in elderly people, thought to be due to over washing and dry winter climate

commonly affects lower limbs causing dry itchy skin adn characteristic ‘crazy paving’ pattern

Question 11

what is asteatotoic eczema treated with

Answer 11

emollients and steroids

Question 12

what drugs and diseases are associated with asteatotic eczema

Answer 12

diuretic use

hypothyroidism

Question 13

acanthosis nigricans

Answer 13

velvety skin in flexural areas of axillae and neck

associated with insulin resistance, obesity and PCOS

Question 14

dermatological manifestations of HIV/AIDS

Answer 14

oral hairy leukoplakia

Kaposi’s sarcoma

Candidiasis

Question 15

ichthyiosis

Answer 15

can be hereditary or acquired

causes dry fish-like scaling of the skin, particularly affecting the limbs

Question 16

what are some causes of acquired ichthyosis

Answer 16

Hodgkin’s, sarcoidosis and internal malignancy

Question 17

what is a genetic cause of ichthyosis

Answer 17

mutation in the filaggrin gene leads to impaired skin barrier and water loss from stratum corneum

• skin doesnt shed its dead skin cells

Question 18

lupus erythematous

Answer 18

persistent, scaly disc like plaques on scalp, face and ears that may cause pigmentary changes, scarring and hair loss

chronic discoid: