Rash

Question 1

Describe a meningococcal rash?

Answer 1

Non-blanching petechial rash

Question 2

What is the most appropriate action if a patient has a non-blanching petechial rash and features of meningitis?

Answer 2

IM benzylpenicillin + immediate referral to hospital Des

Question 3

Describe the key features of eczema

Answer 3

• flexor surface of elbows and knees
• itchy
• dry
• flares up
• excoriations
• history of atopy

Question 4

What is the most appropriate management chronic eczema?

Answer 4

• Regular emollient use (as much and as often as tolerated)

- Avoid precipitants

Question 5

What are the key features of psoriasis?

Answer 5

• dry plaques on extensor surfaces
• excessive dandruff
• nail pitting
• family history

Question 6

What is the most appropriate management of psoriasis?

Answer 6

• Topical corticosteroids

- Phototherapy if severe

Question 7

What are the key features of shingles?

Answer 7

• vesicular rash in a specifiv dermatome
• itchy
• painful

Question 8

What is the most appropriate management of shingles?

Answer 8

• simple analgesia

- Acyclovir if severe/elderly

Question 9

What are the key features of scabies?

Answer 9

• intensely itchy rash
• worse at night
• occurs in household/institutional clusters

Question 10

How is scabies treated?

Answer 10

• Permethrin cream applied over whole body and left on for 12hrs
• treat all house-hold contacts
• careful washing of bed sheets and hoovering carpets
• do not go to school until treated

Question 11

What is the most appropriate management of acne?

Answer 11

Mild - Topical benzoyl peroxide
Mild/moderate - topical clindamycin
Severe - topical retinoid

Question 12

What are the key features of hand foot and mouth disease? What is the cause?

Answer 12

• vesicular rash around mouth and on hands and feet
• usually in young children
• viral prodromal symptoms
• caused by Coxackie virus

Question 13

How is hand, foot and mouth disease managed and what advice would you give to parents?

Answer 13

• supportive treatment
• not related to foot and mouth disease
• cannot be ‘caught’ from pets/animals
• can return to school when feeling well; don’t have to wait until last blister has gone

Question 14

What are the key features of measles?

Answer 14

• unvaccinated child
• erythematous, maculopapular rash that starts on head and spreads over trunk and limbs over 3-4 days
• viral prodrome (including fever)

Question 15

How should measles be managed?

Answer 15

• off school for at least 5 days from symptom onset
• symptomatic relief
• notify public health England
• monitor for complications

Question 16

What are the main complications of measles?

Answer 16

• meningitis
• encephalitis
• febrile seizure
• diarrhoea