Hair, Nails, Drug Eruptions

Question 1

What are vellus hairs?

Answer 1

Fine, short hair covering much of body surface. Replaces lanugo hairs before birth

Question 2

What are terminal hairs?

Answer 2

Long, coarse hairs eg scalp & pubic area. Growth influenced by androgen levels

Question 3

What are lanugo hairs?

Answer 3

Fine long hairs covering the foetus. Shed about 1 month before birth

Question 4

In hair cycle what is the growing phase called?

Answer 4

Anagen phase

Question 5

In hair cycle what is the growing phase called?

Answer 5

Catagen phase

Question 6

In hair cycle what is the growing phase called?

Answer 6

Telogen phase

Question 7

In hair cycle what is the phase called where there is the release of a dead hair??

Answer 7

Exogen phase

Question 8

What is telogen effluvium?

Answer 8

A trigger (e.g. surgery or a nutritional or endocrine imbalance) causes anagen-phase hair follicles to transition prematurely to the telogen phase, resulting in a noticeable increase in shedding of scalp hairs 2-3 months later

Question 9

Name an endocrine cause of generalised hair loss?

Answer 9

Thyroid disease

Question 10

A dietary deficiency of what is likely to cause hair loss?

Answer 10

Iron (zinc and vitamin D are also important)

Question 11

Name 5 types of non-scaring localised hair loss?

Answer 11

1. Alopecia areata
2. Androgenetic
3. Trichotillomania
4. Traction alopecia
5. Tinea capitis

Question 12

Name 4 types of scarring localised hair loss?

Answer 12

1. Burns/trauma
2. CDLE (Cutaneous discoid lupus erythematous)
3. Lichen planus
4. Frontal fibrosing alopecia

Question 13

What treatments are available for alopecia areata?

Answer 13

Topical/systemic steroids
PUVA
DCP (Diphencyprone)
Dithranol

Question 14

What are the investigations for tinea capitis?

Answer 14

Skin scrapping
Hair pluckings
Woods lamp

Question 15

What is the treatment for tinea capitis?

Answer 15

Oral anti-fungal (Griseofulvin)

Question 16

What is the investigation for CDLE (Cutaneous discoid lupus erythematosus)

Answer 16

Clinical + biopsy with DIF (Direct immunofluorescence)

Question 17

What treatments can be given for CDLE?

Answer 17

Potent topical steroids
Hydroxychloroquine
Photoprotection

Question 18

What investigations can be done for androgenetic hair loss (common balding)?

Answer 18

Hormone levels
Iron
Zinc

Question 19

What medication can be used for androgenetic hair loss?

Answer 19

Minoxidil

Anti-androgens (spirolactone)

Question 20

What is the condition which involves unwanted, male-pattern hair growth in women?

Answer 20

Hirsutism

Question 21

Hirsutism is caused by an increase in which hormone?

Answer 21

Androgen

Question 22

Name some causes of hirsutism?

Answer 22

Familial / constitutional – may be assoc. with seborrhoea, acne, androgenetic alopecia
Adrenal hyperplasia or tumour
Ovarian – PCOS or tumour
Pituitary – hyperprolactinaemia
Iatrogenic – e.g. Danazol, Glucocorticoids

Question 23

What is hypertrichosis?

Answer 23

Excessive hair growth in a non-androgenic distribution

Question 24

What is the paronychium?

Answer 24

A soft tissue that surrounds both fingernails and toenails

Question 25

What is the eponychium?

Answer 25

The thickened layer of skin surrounding fingernails and toenails

Question 26

What is the lunula?

Answer 26

The white area at the base of a fingernail

Question 27

What are Beau's lines?

Answer 27

Deep grooved lines that run from side to side on the fingernail or the toenail. They may look like indentations or ridges in the nail plate

Question 28

What causes Beau's line?

Answer 28

Transient arrest in nail growth, which occurs during acute stress/illness

Question 29

What is onycholysis?

Answer 29

The painless detachment of the nail from the nail bed, usually starting at the tip and/or sides

Question 30

What disease is onycholysis most commonly seen in?

Answer 30

Psoriasis

Question 31

What is paronychia?

Answer 31

A nail disease that is an often-tender bacterial or fungal infection of the hand or foot where the nail and skin meet at the side or the base of a finger or toenail

Question 32

Name 2 bacterium which cause acute paronychia?

Answer 32

Staph. Aureus | Strep. Pyogenes

Question 33

What fungal usually causes chronic paronychia?

Answer 33

Candida/can be mould-related

Question 34

What is the cause of sublingual haematoma?

Answer 34

Trauma

Question 35

What is Hutchinson's sign in malignant melanoma of the nail bed?

Answer 35

Spreading pigmentation

Question 36

What is a myxoid cyst?

Answer 36

Benign swelling that occurs on the fingers or, sometimes, the toes

Question 37

What is the most common type of drug eruption?

Answer 37

Exanthematous drug eruption

Question 38

Give some examples of drugs known to cause exanthematous drug eruption?

Answer 38

Penicillins Carbamazepine Allopurinol NSAIDs

Question 39

What is the 2nd most common type of drug eruption?

Answer 39

Drug-induced acute urticaria

Question 40

Give some examples of drugs known to cause drug-induced urticaria?

Answer 40

Antibiotics esp. penicillin NSAIDs ACE inhibitors

Question 41

What is erythema nodosum?

Answer 41

Condition characterized by inflammation of the fat cells under the skin, resulting in tender red nodules or lumps

Question 42

What drugs can cause erythema nodosum?

Answer 42

Sulfonamides | Oral contraceptive

Question 43

What infections can cause erythema nodosum?

Answer 43

Strep. TB Leprosy

Question 44

What autoimmune conditions can cause erythema nodosum?

Answer 44

Sarcoidosis Ulcerative colitis Behçet's disease

Question 45

What is Steven Johnson Syndrome?

Answer 45

A type of severe skin reaction with mucosal erosion and epidermal detachment on <10% of the body's surface, it is associated with fever and flu-like symptoms

Question 46

What is the histology of Steven Johnson Syndrome?

Answer 46

Full thickness epidermal necrolysis

Question 47

What drugs can cause Steven Johnson Syndrome?

Answer 47

Allopurinol, antibiotics, anticonvulsants, NSAIDs

Question 48

In toxic epidermal necrolysis what percentage of the body is affected?

Answer 48

>30%

Question 49

What are the causes of erythema multiforme?

Answer 49

Drugs - sulphonamides, phenytoin, penicillin Infection - herpes simplex, mycoplasma Idiopathic > 50%

Question 50

How are the lesions in erythema multiforme typically described?

Answer 50

Target lesions

Question 51

What drugs can cause hypersensitivity (leukocytoclastic) vasculitis?

Answer 51

``` Allopurinol Amiodarone NSAIDs Thiazide Penicillins Sulphonamides Hydralazine ```

Question 52

What drugs can cause exfoliative dermatitis (erythroderma)?

Answer 52

Barbiturates Gold Quinine Sulphonamides

Question 53

What drugs may cause a fixed drug eruption?

Answer 53

``` Phenolphthalein Antibiotics (tetracyclines) NSAIDs Quinine OCP ```

Question 54

What may cause a drug-induced lichenoid eruption?

Answer 54

B blockers Captopril Thiazides Frusemide

Question 55

What may cause a drug-induced pemphigoid?

Answer 55

Frusemide Penicillamine Penicillin Sulphasalzine

Question 56

What may cause a drug-induced pemphigus?

Answer 56

Penicillamine Captopril Penicillin Gold

Question 57

What may cause drug-induced photosensitivity? (sun distribution rash)

Answer 57

Quinine | Thiazide

Question 58

What may cause a drug-induced LE (lupus erythematous)?

Answer 58

``` Hydralazine Procainamide B blockers Phenytoin Thiazides ```

Question 59

What may cause drug-induced hyperpigmentation?

Answer 59

Chlorpromazine | Minocycline