Last Min Dermatology MRCP

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Dermatology
Acne rosacea treatment:
 mild/moderate: topical metronidazole
 severe/resistant: oral tetracycline
Blisters/bullae
 no mucosal involvement (in exams at least*): bullous pemphigoid
 mucosal involvement: pemphigus vulgaris
Blisters/bullae
 no mucosal involvement: bullous pemphigoid
 mucosal involvement: pemphigus vulgaris
Dermatitis herpetiformis - caused by IgA deposition in the dermis
Dermatophyte nail infections - use oral terbinafine
Discoid lupus erythematous - topical steroids → oral hydroxychloroquine
Dry skin is the most common side-effect of isotretinoin
Flexural psoriasis - topical steroid
Impetigo - topical fusidic acid → oral flucloxacillin / topical retapamulin
Keloid scars - more common in young, black, male adults
Keloid scars are most common on the sternum
Lichen
 planus: purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham's striae over
surface. Oral involvement common
 sclerosus: itchy white spots typically seen on the vulva of elderly women
Management of venous ulceration - compression bandaging
Melanoma: the invasion depth of the tumour is the single most important prognostic factor
Polymorphic eruption of pregnancy is not associated with blistering
Porphyria cutanea tarda
 blistering photosensitive rash
 hypertrichosis
 hyperpigmentation
Psoriasis: common triggers are beta-blockers and lithium
Scabies - permethrin treatment: all skin including scalp + leave for 12 hours + retreat in 7 days
Seborrhoeic dermatitis - first-line treatment is topical ketoconazole

Topical steroids
 moderate: Clobetasone butyrate 0.05%
 potent: Betamethasone valerate 0.1%
 very potent: Clobetasol propionate 0.05%
Urinary histamine is used to diagnose systemic mastocytosis
Waterlow score - used to identify patients at risk of pressure sores
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Stereotypical histories (dermatology)
An elderly women develops itchy, tense blisters around the flexures.
There is no mucosal involvement - bullous pemphigoid
An elderly Jewish woman develops painful, flaccid, easily ruptured
vesicles and bullae on the skin. They are not itchy and were preceded by
mouth lesions - pemphigus vulgaris

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