Dermatology 2

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Questions and Answers

Which of the following blood tests is most likely to be ordered to assess a patient's overall blood cell count and identify potential abnormalities?

  • U+E (Urea and Electrolytes)
  • FBC (Full Blood Count) (correct)
  • LFT (Liver Function Test)
  • CRP (C-Reactive Protein)

A patient presents with symptoms suggesting an autoimmune disorder. Which blood test would be most appropriate to investigate this possibility?

  • Glucose test
  • U+E (Urea and Electrolytes)
  • Herpes simplex serology
  • ANA (Antinuclear Antibody) test (correct)

A patient presents with a suspected viral infection. Which blood test is most suitable for identifying a past exposure to herpes simplex virus?

  • CRP (C-Reactive Protein)
  • Herpes simplex serology (correct)
  • LFT (Liver Function Test)
  • FBC (Full Blood Count)

A patient is being treated for a skin infection and requires a topical agent. Which of the following would be most appropriate?

<p>Antibacterial cream (C)</p> Signup and view all the answers

Which of the following treatments for skin conditions is classified as a systemic agent?

<p>Prednisolone (A)</p> Signup and view all the answers

A patient presents with intense itching but no visible rash. Which skin complaint is most likely?

<p>Pruritus (C)</p> Signup and view all the answers

Lichenification, a common consequence of chronic scratching, is most accurately described as:

<p>Thickening of the skin with accentuated skin markings. (D)</p> Signup and view all the answers

Which type of eczema is most associated with venous insufficiency and blood leakage into the skin?

<p>Varicose eczema (B)</p> Signup and view all the answers

A patient presents with eczema primarily affecting the central face and scalp. This is most indicative of which type of eczema?

<p>Seborrhoeic eczema (B)</p> Signup and view all the answers

A patient with eczema develops yellow crusting and weeping lesions. This suggests a secondary infection with:

<p>Staphylococcus aureus (C)</p> Signup and view all the answers

Acyclovir is a medication specifically recommended in the management of eczema when there is a suspected secondary infection with:

<p>Herpes simplex virus (A)</p> Signup and view all the answers

Which of the following is a typical clinical feature of psoriasis?

<p>Symmetrical, well-defined red plaques with thick silvery scale (A)</p> Signup and view all the answers

Which of the following is the most common location for psoriasis plaques to appear?

<p>Elbows, knees, and back (D)</p> Signup and view all the answers

Which type of psoriasis is often preceded by a streptococcal throat infection?

<p>Guttate psoriasis (A)</p> Signup and view all the answers

Which of the following best describes the lesions associated with psoriasis vulgaris?

<p>Well-defined salmon pink plaques with silvery scale (A)</p> Signup and view all the answers

A patient is diagnosed with psoriasis. Which visible characteristic is most indicative of psoriasis vulgaris?

<p>Well-defined salmon pink plaques with silvery scale. (C)</p> Signup and view all the answers

A patient presents with small, raindrop-sized lesions after recovering from a streptococcal throat infection. Which form of psoriasis is most likely?

<p>Guttate (B)</p> Signup and view all the answers

Where does generalized pustular psoriasis typically present?

<p>Natal cleft and below buttocks (B)</p> Signup and view all the answers

Why should soaps be avoided in patients with eczema?

<p>Soaps can dry out the skin and exacerbate inflammation. (C)</p> Signup and view all the answers

What is the primary purpose of using emollients in the management of eczema?

<p>Hydrating the skin and restoring the skin barrier (C)</p> Signup and view all the answers

Flashcards

Haematology tests

FBC, ESR

Biochemistry tests

U+E, LFT, glucose, CRP

Immunology tests

ANA, DNA, organ-specific antibodies

Virology tests

Herpes simplex serology

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Topical infection management

Antibacterial agents, Candida corticosteroids creams, Mouthwash

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Systemic infection management

Prednisolone +/- steroid sparing agents, Antibiotics

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What is Eczema?

Eczema is a pruritic inflammatory condition associated with dryness and erythema of skin

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Result of scratching eczema

Lichenification and excoriation

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Irritant contact eczema

Over-handwashing

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Allergic contact dermatitis

Make up

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Key clinical feature of psoriasis

Symmetrical well-defined red plaques with thick silvery scale

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Common sites for psoriasis

Elbows, knees, back

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Psoriasis vulgaris

Chronic plaque psoriasis; Well-defined salmon pink plaques with silvery scale

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Guttate Psoriasis

Raindrop size lesions often follows a streptococcal throat infection

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Study Notes

Types of Blood Tests

  • Four test types are used to investigate blood in unwell patients: Haematology, Biochemistry, Immunology, and Virology.
  • Haematology tests include FBC (Full Blood Count) and ESR (Erythrocyte Sedimentation Rate).
  • Biochemistry tests include U+E (Urea and Electrolytes), LFT (Liver Function Test), glucose, and CRP (C-Reactive Protein).
  • Immunology tests include ANA (Antinuclear Antibody), DNA antibodies, and organ-specific antibodies.
  • Virology tests include Herpes simplex serology.

Topical Agents for Managing Infection

  • Antibacterial agents are used topically to manage infections.
  • Candida corticosteroids creams are used topically to manage infections.
  • Mouthwash is used topically to manage infections.

Systemic Agents for Managing Infection

  • Prednisolone, possibly with steroid-sparing agents, are systemic agents used to manage infections.
  • Antibiotics are systemic agents used to manage infections.

Common Skin Complaints

  • Eczema is a common skin complaint.
  • Psoriasis is a common skin complaint.
  • Lichen planus is a common skin complaint.
  • Pruritus (severe itching of the skin) is a common skin complaint.
  • Skin infections are a common skin complaint.

Eczema

  • Eczema is a pruritic inflammatory condition marked by skin dryness and erythema.
  • Scratching can lead to lichenification and excoriation of the skin.

Types of Eczema

  • Atopic/flexural eczema typically occurs in the flexures of the skin.
  • Varicose eczema is a progression of atopic eczema resulting from venous incompetence. Blood leaks onto the skin, causing irritation.
  • Seborrhoeic eczema appears in the center of the face and scalp.
  • Discoid eczema presents as coin-shaped lesions on the legs.
  • Lichen simplex is caused by scratching.

Secondary Infections of Eczema

  • Irritant contact, such as from over-handwashing, can lead to secondary infection of eczema.
  • Allergic contact dermatitis, for example, from makeup, can lead to secondary infection of eczema.
  • Staphylococcus aureus can cause impetiginised eczema, characterized by yellow crust and weeping.
  • Herpes simplex can cause eczema herpeticum, characterized by monomorphic lesions.

Eczema Management

  • Avoid soap to manage eczema.
  • Use emollients like soap substitutes and moisturizers to manage eczema.
  • Use topical steroids to manage eczema.
  • Oral antibiotics can be used to manage eczema.
  • Antihistamines (sedatives) can be used to manage eczema.
  • Wet wraps can be used to manage eczema.
  • Acyclovir is used if herpes simplex is suspected (eczema herpeticum).

Psoriasis

  • Symmetrical, well-defined red plaques with thick silvery scales are key clinical features.
  • Common sites include elbows, knees, and the back.

Types of Psoriasis

  • Vulgaris
  • Guttate
  • Erythrodermic
  • Pustular

Psoriasis Vulgaris

  • Psoriasis vulgaris consists of chronic plaque psoriasis.
  • Well-defined salmon pink plaques with silvery scales characterize it.

Guttate Psoriasis

  • Guttate psoriasis consists of raindrop-sized lesions that often follow a streptococcal throat infection.

Generalised Pustular Psoriasis

  • Generalised pustular psoriasis presents itself in the natal cleft and below the buttocks.

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