Rashes

Question 1

Assessment of any rash

Answer 1

Detailed history

Examination - distribution/sites affected, morphology, secondary features

Question 2

Which areas does rosacea affect?

Answer 2

Nose, skin, cheeks and forehead

Question 3

At which age does rosacea tend to present?

Answer 3

30-60 years

Question 4

Clinical features in rosacea

Answer 4

Papules, pustules and erythema
Sometimes enlarged/unshapely nose - rhinophyma
Conjunctivitis/gritty eyes

Question 5

What can exacerbate the prominent facial flushing in rosacea?

Answer 5

Sudden change in temperature, alcohol, spicy food

Question 6

Suspected aetiology of rosacea

Answer 6

Dermodex mite

Question 7

Management for rosacea

Answer 7

Reduce aggravating factors
Topical therapies
Oral therapies
Vascular laser for telangiectasia
Surgery/laser shaving for rhinophyma

Question 8

Topical therapies for rosacea

Answer 8

Metronidazole, ivermectin

Question 9

Oral therapy for rosacea

Answer 9

Oral tetracycline long term

Isotretinoin low dose if severe

Question 10

Which age group does lichen planus tend to affect?

Answer 10

Middle-age

Question 11

Clinical features of lichen planus

Answer 11

Violaceous (pink/purple) flat-topped shiny papules, typically affecting volar wrists/forearms, shins and ankles
Wickham’s striae
Intensely itchy

Question 12

Wickham’s striae

Answer 12

Fine lace-like pattern on surface of papules and buccal mucosa

Question 13

How long does lichen planus usually last?

Answer 13

12-18 months before burning out

Question 14

Management of lichen planus

Answer 14

Check for possible drug precipitant
Emollients
Treat symptomatically - topical steroids (potent or very potent) or oral steroids (if extensive)
UVB phototherapy or PUVA