Skin Infection

Question 1

What is tinea?

Answer 1

Dermatophyte fungal infection

Question 2

What is this a presentation of?

Prepubertal child, scaly area with broken hair on scalp, may have scarring alopecia.

Answer 2

Tinea capitis

Question 3

What happens to tinea capitis if left untreated?

Answer 3

Raised, spongy/boggy mass called a kerion may form.

Question 4

Which organism commonly causes tinea capitis?

Answer 4

Trichophyton tonsurans

Question 5

How is tinea capitis diagnosed and treated?

Answer 5

1. Scalp scrapings

2. Oral antifungal terbinafine and ketoconazole shampoo

Question 6

What is this a presentation of?

Well defined, round, scaly, itchy lesion. Edge is more inflamed than centre. Trunk and limbs commonly.

Answer 6

Tinea corporis (ringworm)

Question 7

How is tinea corporis diagnosed and treated?

Answer 7

1. Skin scrapings of ring edge

2. Topical antifungal terbinafine/imidazole BD for 2 weeks/oral fluconazole.

Question 8

What is this a presentation of?

Itchy, peeling skin between toes.

Answer 8

Tinea pedis (athletes foot)

Question 9

What is the treatment for tinea pedis (athletes foot)?

Answer 9

Topical imidazole/terbinafine

Question 10

What causes candida albicans?

Answer 10

Commensal yeast in mouth and gastrointestinal tract.

Question 11

What is this a presentation of?

Pink, moist skin +/- satellite lesions in mouth, vagina, glans penis, and skin folds.

Answer 11

Candida albicans

Question 12

How is candida albicans treated on the skin?

Answer 12

Imidazole cream

Question 13

How is candida albicans treated in the mouth?

Answer 13

Nystatin oral suspension/miconazole gel

Question 14

How is candida albicans treated in the vagina?

Answer 14

Imidazole cream and pessary (Canesten combi)

Question 15

Which organisms are commonly responsible for impetigo?

Answer 15

Staphylococcus aureus or Streptococcus pyogenes

Question 16

What is this a presentation of?

3-5 year old, golden crusted skin lesion around nose and mouth. Can occur on limbs not covered by clothing.

Answer 16

Impetigo

Question 17

How contagious is impetigo?

Answer 17

Highly contagious, can spread through toys and clothing.

Question 18

What is the treatment for limited/localised impetigo?

Answer 18

Topical fusidic acid

Question 19

What is the treatment for extensive impetigo?

Answer 19

Oral flucloxacillin

Question 20

How long should children be excluded from school for if they have impetigo?

Answer 20

1. Until lesions are crusted and healed
   Or
2. 48 hours after starting antibiotics

Question 21

What causes warts?

Answer 21

Human papilloma virus

Question 22

What is a verruca?

Answer 22

A plantar wart

Question 23

When should you treat warts?

Answer 23

If they are painful, unsightly, or persisting (90% disappear within 2 years without treatment)

Question 24

What is the treatment for warts?

Answer 24

1. Topical salicylic acid gel daily for 12 weeks

2. Cryotherapy once per month for 4 cycles

Question 25

What is the treatment for genital warts?

Answer 25

1. Topical podophyllum for multiple | 2. Cryotherapy for solitary, keratinised

Question 26

What causes molluscum contagiosum?

Answer 26

Molluscum contagiosum virus (pox virus)

Question 27

What is this a presentation of? | 1-4 years old, pinkish/pearly white papules with central umbilication, up to 5mm in diameter.

Answer 27

Molluscum contagiosum

Question 28

What is the curative treatment for molluscum contagiosum?

Answer 28

1. Treatment NOT recommended (resolves within 18 months) | 2. Cryotherapy in older children/adults if painful/unsightly

Question 29

What is the symptomatic treatment for molluscum contagiosum?

Answer 29

1. If itchy - emollient and hydrocortisone | 2. If infected (oedema and crusting) - topical fusidic acid

Question 30

What is this a presentation of? | Severe gingivostomatitis, cold sores, or painful genital ulceration.

Answer 30

Herpes simplex virus infection

Question 31

How is gingivostomatitis (HSV-1) treated?

Answer 31

PO acyclovir and chlorhexidine mouth wash

Question 32

How is genital herpes (HSV-2) treated?

Answer 32

PO acyclovir

Question 33

Which virus causes herpes zoster?

Answer 33

Varicella zoster virus

Question 34

What is this a presentation of? | Acute, unilateral, painful, blistering rash in a dermatomal pattern.

Answer 34

Herpes zoster infection

Question 35

How is herpes zoster treated?

Answer 35

PO acyclovir

Question 36

How is herpes zoster infection protected against in the elderly population?

Answer 36

Live-attenuated SC shingles vaccine offered to all ages 70-79.

Question 37

What is this a presentation of? | Child/young adult, widespread pruritus affecting fingers, interdigital webs, flexor aspect of wrist, axillae.

Answer 37

Scabies (infestation)

Question 38

Who should be treated when someone is diagnosed with scabies?

Answer 38

All members of the household and close contacts regardless of symptoms.

Question 39

What is the management for scabies?

Answer 39

1. Permethrin 5% cream 1st line (malathion 0.5% 2nd line) 2. Clean all clothing, bedding, towels. 3. Warm both, soap skin, scrub fingers and nails with brush, cream body, wash off after 24 hours, repeat every 7 days.

Question 40

What may worsen in treatment of scabies and how is this mitigated?

Answer 40

1. Pruritus | 2. Crotamiton cream

Question 41

How do headlice spread and what is the recommendation for exclusion from school?

Answer 41

1. Head to head contact (lice can't jump) | 2. No school exclusion advised

Question 42

What is the management for headlice infection?

Answer 42

1. Regular combing of hair with fine-tooth comb | 2. Malathion/Dimeticone