Rash: Clinical Cases

Question 1

1st line management for acne

Answer 1

doxycycline PO for 6 months +

topical retinoid

Question 2

2nd line management for acne

Answer 2

isotretinoin PO with oral steroids as anti-inflammatory if initial reaction

Question 3

most common age groups in females and males for acne?

Answer 3

F = 14-17
M = 16-19

Question 4

what are the two types of comedone?

Answer 4

open (blackhead) and closed (whitehead)

Question 5

what aggravates rosacea?

Answer 5

wine, curry, changes in temperature

Question 6

morphology of rosacea?

Answer 6

erythema, pustules, papules, swelling, rhinophyma, gritty eyes/conjunctivitis, telangietic vessels of nose

Question 7

why are there no comedones in rosacea?

Answer 7

doesn’t involve the pilosebaceous unit

Question 8

management of rosacea?

Answer 8

avoid dietary triggers, steroids, sun exposure
TOPICAL- metronidazole, ivermectin (demodex mite)
PO- tetracycline, isoretinoin (if severe)

Question 9

how are the papules and plaques of lichen planus different from others?

Answer 9

they are shiny and flat topped with wickham’s striae (white lines)

Question 10

most common areas affected by lichen planus?

Answer 10

volar wrists, forearms, shins, ankles

Question 11

treatment for lichen planus?

Answer 11

1. topical steroids

2. steroids PO

Question 12

in what condition would nikolskys sign be positive

Answer 12

pemphigus vulgaris

Question 13

what is nikolskys sign?

Answer 13

the top layers of the skin slip away from the lower layers when slightly rubbed

Question 14

how does the early presentation of pemphigus differ from pemphygoid?

Answer 14

pemphigus- urticated itchy plaques first

pemphygoid- bullae on erythematous skin first

Question 15

investigation for bullous pemphygoid?

Answer 15

skin biopsy

direct/indirect immunofluorescence