Skin

Question 1

What does erythema of the skin indicate?

Answer 1

Increased perfusion

Question 2

What is the difference between a bulla and a vesicle?

Answer 2

A vesicle is a blister <5mm and a bulla is a blister >5mm

Question 3

What condition is a port wine stain associated with?

Answer 3

Sturge-Weber - which is itself associated with epilepsy

Question 4

Coeliac disease is associated with which skin sign?

Answer 4

Dermatitis herpetiforms

Question 5

Lupus pernio is associated with which condition?

Answer 5

Sarcoidosis

Question 6

Grave’s disease is associated with which dermatological condition?

Answer 6

Pre-tibial myxoedema

Question 7

Tuberose sclerosis is associated with a triad of which features? (only one is derm)

Answer 7

1. Adenoma sebaceum
2. Epilepsy
3. Low IQ

Question 8

75% of leg ulcers are of which origin?

Answer 8

Venous

Question 9

What are the causes of venous leg ulcers? (2)

Answer 9

1. DVT
2. Varicose veins
   - basically due to venous insufficiency either of superficial or deep venous system

Question 10

What are the large vessel arterial ulcers caused by?

Answer 10

Ischaemia - atheroma and Beurger’s disease

Question 11

What are the small vessel arterial ulcers caused by?

Answer 11

Vasculitis - polyarteritis nodosa and RA

Question 12

What are the causes of neuropathic ulcers? (4)

Answer 12

1. Diabetes
2. Alcohol
3. Tabes dorsalis
4. Syringomyelia

Question 13

How can you distinguish between ischaemic and neuropathic ulcers?

Answer 13

Ischaemic = painful, cold temperature and sensation intact
Neuropathic = painless, warm temperature and absent sensation

Question 14

What is cellulitis?

Answer 14

An infection of skin and subcutaneous tissues

Question 15

What is the main cause of cellulitis normally?

Answer 15

Streptococcus pyogenes

Question 16

What is the predisposing factor for cellulitis?

Answer 16

Leg oedema

Question 17

How will the affected area present with cellulitis? (4)

Answer 17

1. Erythematous
2. Hot
3. Swollen
4. Blisters/necrosis

Question 18

What is the management for cellulitis?

Answer 18

Bed rest
Flucloxacillin
If recurrent episodes - prophylactic ABX

Question 19

What is the most common organism to cause folliculitis?

Answer 19

Staph aureus

Question 20

How can folliculitis be described?

Answer 20

A small pustule on an erythematous base, centred on a follicle

Question 21

What can folliculitis develop into?

Answer 21

Furunculosis (boil) - a deep infection of a hair follicle by staph. aureus.

Question 22

How can a furunculosis present?

Answer 22

Painful, inflammatory nodule, red and pus-filled lumps that are tender, warm and painful. Often a yellow or white point at the centre of the lump can be seen when the boil is ready to drain.

Question 23

What is the treatment for lupus vulgaris?

Answer 23

Standard anti-tuberculosis therapy - Rifampicin, Isoniazid and Pyrazinamide

Question 24

What is the cause of genital warts?

Answer 24

HPV - increased risk of penile and cervical cancer

Question 25

What virus causes molluscum contagiosum?

Answer 25

POX

Question 26

What are the classical features of molluscum contagioum?

Answer 26

Pearly pink papules with central umbilication

Question 27

What is the treatment for scabies? (5 but one most common)

Answer 27

1. Benzylbenzoate emulsion
2. Lindane lotion
3. Monosulfiram solution
4. Aqueous malathion
5. 5% permethrin cream (this one is used most)

Question 28

Which mnemonic is useful for remembering the causes of erythema nodosum? (and what are the causes)

Answer 28

SORE SHINS
S - streptococci
O - OCP
R - rickets
E - eponymous (Behcets)
S - sulfonamides
H - Hansen's disease (leprosy) 
I - IBD
N - NHL
S - sarcoidosis