QUEEEEEE

Question 1

Penicillin-induced urticaria - wheals present on examination.
What treatment ?

Answer 1

Antihistamines (allergic manifestation)

If it recurs/persists then prescribe steroids

Question 2

Clusters of intensely pruritic vesicles and papules + diarrhoea.
Rash is symmetrically located on the extensor surfaces such as elbows, buttocks or shoulders

Answer 2

Dermatitis herpetiformis

Question 3

Treatment for dermatitis herpetiformis

Answer 3

Dapsone
(antibiotic that reduces pruritic symptoms)

+ gluten free diet obvislyyyy

Question 4

Lyme disease - what is the name of the rash associated ?

Answer 4

Erythema migrans

BULLSEYE LESION

(Erythema multiforme = triggered by recent illness)

Question 5

Psoriatic arthritis - what is seen on X-ray ?

Answer 5

Periarticular erosions and joint space narrowing

Question 6

Genotype most associated with type 1 diabetes

Answer 6

HLA-DR3

Question 7

Cause of pyogenic granuloma + what is it ?

Answer 7

Microtrauma

Benign, reactive overgrowth of capillary blood vessels caused by microtrauma to the finger

Question 8

Fluid-filled blisters on the back of his hand which are fragile and rupture easily resulting in erosions.
Hypertrichosis of the malar region of the cheek.

1. Rash 2. Hypertrichosis
   Diagnosis ?

Answer 8

Porphyria cutanea tarda

Question 9

Triggers for psoriasis ?

Answer 9

Skin trauma (Koebner phenomenon)
Infection: Streptococcus, HIV
Drugs: B-blockers, Anti-malarials, Lithium, Indomethacin/NSAIDs (BALI)
! Withdrawal of steroids !
Stress
Alcohol + smoking
Cold/dry weather

Question 10

Dandruff + scaly red patches with associated flaking =

Answer 10

Seborrhoeic dermatitis

(reaction to yeast in skin - affects areas with lots of sebaceous glands)

Question 11

Treatment for seborrhoeic dermatitis

Answer 11

Topical antifungals + antifungal body wash

Topical corticosteroids if symptoms are particularly severe

Question 12

Eczema treatment

Answer 12

Emollients with/without steroids

(Hydromol cream and topical clobetasone butyrate 0.05%)

Question 13

Strawberry tongue + sandpaper rash

Answer 13

Scarlet Fever

Question 14

Lichen planus features ?

Answer 14

6 Ps:

Purple
Pruritic
Polygonal (multiple sides)
Planar (flat-topped)
Papules or
Plaques

Question 15

Treatment for lichen planus with oral involvement

Answer 15

Potent topical steroids + benzydamine mouthwash

Question 16

Rapidly growing nodule with central crusted depression
- develops from hair follicles in skin exposed to the sun

Answer 16

Keratoacanthoma

can be clinically indistinguishable from squamous cell carcinoma

Question 17

Keratoacanthoma first line treatment

Answer 17

Surgical excision

• indistinguishable from SCC so better to remove

Question 18

Cause of alopecia associated with chemotherapy

Answer 18

Anagen effluvium

Question 19

Rash becomes more obvious on holiday as lesions don’t tan

Answer 19

Pityriasis versicolor
a.k.a. tinea versicolor

Question 20

Treatment for pityriasis versicolor ?

Answer 20

Topical ketoconazole

(antifungal)

Question 21

Rough patch on sun-exposed skin

Can be a white, scaly plaque or just a discoloured rough patch

Answer 21

Actinic keratosis

• pre-cursor to SCC which presents as a raised lesion prone to ulceration/bleeding

Question 22

Treatment for molluscum contagiosum ?

Answer 22

Watch and wait - conservative management is best

Question 23

Allergic contact dermatitis - which white blood cell is associated ?

Answer 23

T lymphocytes

• cause a delayed type IV hypersensitivity reaction

Question 24

Does basal cell carcinoma require urgent referral ?

Answer 24

No

unless it’s in a concerning area e.g. eyelids , or it’s notably large

Question 25

Treatment for eczema herpeticum ?

Answer 25

IV aciclovir

Question 26

Complications of untreated eczema herpeticum

Answer 26

Herpetic hepatitis, encephalitis, DIC