Dermatology

Classification of acne vulgaris (X3).

mild: open and closed comedones with or without sparse inflammatory lesions

moderate acne: widespread non-inflammatory lesions and numerous papules and pustules

severe acne: extensive inflammatory lesions, which may include nodules, pitting, and scarring

1st line Tx recommended in those with mild-moderate acne.

12-week course of topical combination therapy

Options for 1st line Tx in mild-moderate acne.

topical adapalene with topical benzoyl peroxide

topical tretinoin with topical clindamycin

topical benzoyl peroxide with topical clindamycin

Rules for prescribing antibiotics in the Tx of acne.

Max. 3M therapy + in combination with topical Tx

Typical 1st presentation of eczema.

2Y - dry/itchy patches over face and neck.

Most common cause of bacterial infection in eczema.

S. aureus (Tx w/ flucloxacillin)

Cause of eczema herpeticum - rapidly progressive viral skin infection.

HSV-1 or HSV (Tx w/ IV acyclovir)

Necessary inv., in ?eczema.

Patch Test - irritants

Skin Prick Test - allergens

4 rungs to the steroid ladder.

Hydrocortisone

Eumovate

Betnovate

Dermovate

4 types of psoriasis.

Plaque, guttate, pustular and erythrodermic

Thickened, erythematous plaques w/ silver scales.

Plaque

Psoriasis most common in children - small raised papule across the trunk and limbs - eventually turns to plaque.

Guttate

Potential triggers for guttate psoriasis in children (X3).

Stress

Streptococcal Infection

Medication

Gene associations with psoriasis.

HLA-B13

HLA-B17

HLA-Cw6

Development of lesions within areas of trauma, psoriasis, lichen planus.

Koebner Phenomenon

What layers of skin are affected by cellulitis?

Dermis and deeper s/c tissue

Stages of the Eron classification that define the management of cellulitis.

I - no systemic symptoms or uncontrolled co-morbidities

II - co-morbidities

III - significant systemic upset

IV - severe or life-threatening infection

When would you consider admitting for IV Abx in cases of cellulitis (X6)?

- Eron III or IV

- Deteriorating cellulitis

- <1 or frail

- Immmunocomp.,

- Lymphoedema

- Facial cellulitis

Management of different classifications of Eron classification in cellulitis.

I - PO Flucloxacillin

II - Admit if inadequate comm. facilities

III or IV - admit for IV

Name of head lice Tx

Malathion

Causative organism in impetigo

S. aureus

1st line Tx in impetigo

Hydrogen peroxide 1%

1st line Tx for scabies

5% pemethrin cream

Tx for crusted scabies (HIV)

Ivermectin

Causative organism in pityriasis versicolour

Malassezia

How would you treat urticaria?

1. non-sedating antihistamines (i.e., loratidine) for 6W

2. sedating for nighttime symptoms

3. prednisolone if resistant

4 most common sites for pressure sores

ischial tuberosity

heel

lateral malleolus

greater trochanter

Type of precancerous dermatosis that is a precursor to squamous cell carcinoma.

Bowen's Disease

Necessary Mx (normally primary care) for Bowen's Disease.

1) topical 5-fluorouracil - used twice daily for 4 weeks often results in significant inflammation/erythema.

2) cryotherapy

3) excision

4 X Types of Malignant Melanoma

Superficial Spreading (70%)

Nodular (Invade aggressively and metastasise early)

Lentigo maligna

Acral lentiginous - palms/soles

6 X RFs for SCC

Sunlight Exposure

Actinic Keratoses

Immunosuppresion

Smoking

Leg Ulcers

Previous Thermal Injury

Infection that can precede guttate psoriasis flare-up.

Streptococcal Pharyngitis