Skin Q

Question 1

Rubella

Answer 1

• Viral
• Red or pink rash starts behing the ears and on face and spreads
• Mild fever, headache, sore throat, enlarged lymph nodes

Question 2

According to the NICE guidelines and BNF, what should be the maximum duration of treatment with a potent corticosteroid?

Answer 2

56
treatment may be restarted after 4 week break

Question 3

squamous cell carcinoma

Answer 3

• Mouth ulcer for 3 weeks
• no pain
• 1cm in diameter

Question 4

Isotretinoin Rx

Answer 4

• Isotretinoin under ppp should be considered expired 7 days after date on rx
• Pregnancy test must be done as part of ppp
• If pt is not under ppp a supply of more than 30 days can be made
• Under ppp max 30 days of treatment can be made

Question 6

Basal cell carcinoma

Answer 6

• Skin cancer
• Shiny, pearly or translucent bumps with small blood vessels
• Occurs with UV, sunburn, tanning beds, esp on white ppls

Question 7

Angular chelitis

Answer 7

• Red sore fissures at the corners of mouth

Question 8

Amorphous ulcers

Answer 8

• Minor: 1cm in size, can occur singlely or up to 5 ulcers at a time
• Major: greater than 1cm in size and up to 10 at a time

Question 10

Perioral dermatitis

Answer 10

• Similar to acne
• Red bumps on lower half of face

Question 11

Are painless lesions a red flag

Answer 11

Yes could be leukoplakia

Question 12

Diabetics with fungal infection

Answer 12

could indicate hyperglycaemia

Question 13

Which medication can cause psoriasis?

Answer 13

• Lithium
• Antimalarials
• BB
• NSAIDs
• ACEi
• Abx e.g. tetracycline + penicillin

Question 14

The mother of a two-year-old has noticed greyish-white spots in the child’s mouth. What is the most likely condition?

Answer 14

Measles

Question 15

Which skin products are able to cause teratogenicity? →

Answer 15

oral retinoids e.g., isotretinoin - conditions of a pregnancy prevention programme (PPP) must be met for women and girls of childbearing potential being treated with oral retinoids!

Question 16

periungual pyogenic granulomas

Answer 16

Roaccutane
- known yet uncommon and potentially severe side effect of the oral vitamin A derivative.

Question 17

What are the counselling points to give patients when using an emollient?

Answer 17

1) apply in the direction of hair growth to reduce the risk of folliculitis
2) apply just after washing as the hydration effect is maximised
3) do NOT share to reduce bacterial contamination
4) may be more suitable to use ointments at night and creams during the day
5) WAIT 15-30 minutes after application of an emollient before applying a topical steroid!

Question 18

Adapalene counselling

Answer 18

• can cause hypo and hyperpigmentation
• protect from sunlight
• start with alternate day or short contact application
• use a non comedogenic moisturiser may help with tolerability

Question 19

How to prevent the spread of impetigo

Answer 19

• stay away from work for 48 hrs after starting abx

Question 20

1st line psoriasis exacerbation

Answer 20

mom 0.1% cream

Question 21

Skin rash with small dimple in the middle

Answer 21

molloscum contagiosum
viral infection
self limiting

Question 22

Miliaria

Answer 22

Heat rash
Obstruction of sweat glands

Question 23

When should you retreat with permethrin cream?

Answer 23

If symptoms persist for longer than 2-4 weeks after last application

Question 24

Scabies advice and counselling

Answer 24

• Itching may continue for up to 4 weeks after treatment
• All membersof household should be treated if they are symptomatic or not

Question 25

According to the NICE guidelines and BNF, what should be the maximum duration of treatment with this topical Vitamin D preparation?

Answer 25

56 days