Derm

Question 1

Eczema Dx?

Answer 1

Must have itchy skin plus >2 of following

History itchy flexor skin crease
History atopy
General dry skin
Visible flexural eczema (in adults)
Onset in first 2 years of life

Question 2

Eczema Mx

Answer 2

Emollients - should be 500g/week for an adult

More flares = higher lipid content

Topical steroids

Question 3

Eczema coms

ps

Answer 3

Psychosocial

Infection - staph aureus

Question 4

3 main types of psoriasis

Answer 4

Plaque - usual
Guttate - widespread fine scale on trunk, arms, legs. Often follows URTI
Pustular - URGENT referral

Question 5

Mx of mild / severe psoriasis

Answer 5

Mild - topical steroids

Mod/severe - methotrexate, phototherapy, oral retinoids (not for girls), biologics Eg infliximab (TNFa blocker)

Question 6

Mx of guttate / pustular psoriasis

Answer 6

Guttate - phototherapy, MTX, oral retinoid

Pustular - dermatology referral

Question 7

Rapid growing, dome shaped, well defined core

Answer 7

keratocanthoma

Question 8

irregular, keratinous nodule on lip

Answer 8

SCC

Question 9

slow growing, ‘pearly’ nodule, some telangiectasia

Answer 9

Basal cell carcinoma

Question 10

Rodent ulcer

Answer 10

BCC

Question 11

Common thing that looks like a normal mole with dark patches - ‘stuck on’ appearance

Answer 11

Seborrhoeic keratoses

Question 12

How to describe skin thing

Answer 12

a - asymmetry
b - well defined irregular border
c - variation in colour (blue tinge under dermatoscope)
d - diameter over 6mm
e - evolving

Question 13

what Mx available in severe eczema

Answer 13

oral steroids
azathioprine / ciclosporin
paste bandaging
phototherapy

Question 14

Ig raised in severe eczema

Answer 14

IgE

Question 15

Describe an eczema lesion

Answer 15

erythematous, scaly, excoriations, crust

Question 16

Describe a plaque psoriasis

Answer 16

red scaly, well demarcated

Question 17

what is koebner phenomenom

Answer 17

psoriasis lesions which develop at site of injury

Question 18

20 year old Jew comes in with blisters all over body and mouth that easily burst =?
2 Ix?
Mx?
2 main causes

Answer 18

pemphigus vulgaris

biopsy
screen for antibodies

Immunosupression / high dose steroids

drug induced / autoimmune

Question 19

Which one is like pemphigus but less popping of bulla ?

Answer 19

bullous pemphigoid

Question 20

Indicator of prognosis in melanoma

Mainstay of Mx ?

Answer 20

breslow thickness

Wide local excisison

Question 21

Bar skin 2 places you can get a melanoma

Answer 21

GI tract, CNS, choroid of eye

Question 22

Most aggressive form of melanoma?

Answer 22

nodular malignanat

Question 23

BCC - describe 3 main feautres ?

3DDx?

Answer 23

Small, pearly white nodule, telangiectasia, rolled edge, central ulcer, may be pigmented

SCC, melanoma, fibrous plaque , actinic keratosis

Question 24

Best Mx of BCC

Answer 24

Mohs micrographic surgery

Question 25

Common bug in acne

Answer 25

p acnes

Question 26

what happens in acne

Answer 26

increased sebum production | -> blocked pilosebaceious follicles become infected

Question 27

isotrenitoin SEs

Answer 27

``` dry skin / eyes depression teratogenicity migrain muscle aches ```

Question 28

most common chronic comp of shingles

Answer 28

post-herpetic neuralgia

Question 29

4 grades of pressure sore 4 RFs 4Mx points

Answer 29

1 - non blanching erythema 2- partial thickness 3 - full thickness of skin -> subcutaneous fat 4- involvement of muscle / bone / supporting tissue Elderly, CV disease, obesity, malnutrition, immobility, neurologically impaired, incontinence ``` Nutrition Abx if needed regular dressings debridement pain relief pt positioning pressure relieving mattress . chair ```

Question 30

``` lichen scleorisis 3 DDx? 2 sx? 1 Ix? Mx? 2 comps? ```

Answer 30

vitiligo, SCC, bowens, lichen plannus, scleroderma Itching, dyspareunia, constipation Biosy, swab Topical steroids / emmolents / lube SCC, scarring, dysparenunia, constipation

Question 31

Bad viral eczema in kids ?

Answer 31

Eczema herpeticum