Skin

Question 1

Scabies description

Answer 1

red spots with silvery interlinking lines - usually in webbing of fingers/toes

Question 2

Scabies Treatment

Answer 2

• Malathion or Permethrin twice - 1 week apart
• apply to whole body and face
• treat all family
• avoid physical contact with other members of family
• wash clothes and sheets

Question 3

Head lice description

Answer 3

Live moving lice with white eggs distributed

Question 4

Head lice non-drug treatment

Answer 4

wet-combing - comb for 30 minutes at 4 day intervals until no lice for 3 sessions for minimum of 2 weeks

Question 5

Head lice drug treatment

Answer 5

• Dimeticone - leave in for 8 hours, dry naturally, repeat after 7 days
• Malathion - leave in for 12 hours, dry naturally, repeat after 7 days, avoid in severe eczema/asthma due to alcohol contents

Question 6

Not recommended for head lice treatment

Answer 6

• benzyl benzoate
• permethrin

Question 7

Head lice treatment MHRA Warning

Answer 7

some preparations are flammable

Question 8

Eczema description

Answer 8

• dry, flaky skin
• small red spots
• usually in body creases

Question 9

Types of eczema

Answer 9

• irritant
• allergic
• contact
• atopic

Question 10

Eczema emollients directions for use

Answer 10

• apply OR as bath/shower emollients
• avoid aqueous cream due to high risk of skin reactions

Question 11

Eczema topical corticosteroids on face and genitals

Answer 11

Mild hydrocortisone - can’t advise OTC

Question 12

Antihistamines can’t be used for which type of eczema

Answer 12

atopic dermatitis

Question 13

Treatment for mild - mod eczema

Answer 13

pimecrolimus

Question 14

Treatment for mod - severe eczema

Answer 14

tacrolimus

Question 15

Treatment for severe refractory eczema

Answer 15

systemic medication required:
- ciclosporin
- azathioprine
- mycophenolate mofetil
- MoAbs

Question 16

Psoriasis description

Answer 16

• skin thickening and silvery white scaling, raised and larger patches/plaques
• systemic, immune-mediated inflammatory skin disease
• can be in joints too - psoriatic arthritis

Question 17

Treatment options for psoriasis

Answer 17

• emollients
• topical corticosteroids
• coal tar preparations
• vitamin D (topical or analogues)

Question 18

Psoriasis treatment when topicals fail

Answer 18

• phototherapy - UVA/UVB
• systemic tx - MTX, ciclosporin, acitretin (2nd line)

Question 19

Topical corticosteroids strength from mild to very potent

Answer 19

• Mild = hydrocortisone - OTC 7 days
• Moderate = clobetasone
• Potent = beclomethasone
• Very potent = clobetasol

Question 20

Prolonged use of corticosteroids causes?

Answer 20

Skin thinning
- apply thinly - 1 fingertip covers SA of hand
- don’t apply to broken skin

Question 21

Acne treatment options

Answer 21

• benzoyl peroxide
• adapalene
• clindamycin
• lymecycline/doxycycline
• erythromycin
• isotretinoin (severe)

Question 22

Isotretinoin MHRA Warnings

Answer 22

• rare erectile dysfunction and decreased libido
• PPP (teratogenic) - contraception 1 month before and after, each Rx limited to 30 days supply and valid for 7 days only
• risk of neuropsychiatric reactions - medical attention if mood change
• avoid UV light, laser skin tx, dermabrasion, epilation

Question 23

Dandruff (seborrheic dermatitis) Treatment options

Answer 23

• antimicrobial - pyrithione zinc, selenium, tar extracts
• more persistent/severe = ketoconazole shampoo
• psoriasis of scalp = coal tar and salicylic acid

Question 24

Hirsutism causes

Answer 24

hormonal or due to drugs e.g. phenytoin

Question 25

Hirsutism treatment

Answer 25

• Weight loss in women helps
• laser therapy
• eflornithine
• co-cyprindiol

Question 26

alopecia tx

Answer 26

finasteride or minoxidil