Each one of the following is associated with yellow nail syndrome except:
Correct Answer C:
Yellow nail syndrome: Slowing of the nail growth leads to the characteristic thickened and discoloured nails seen in yellow nail syndrome.
Associations:
A 54-year-old woman is prescribed topical fusidic acid for a small patch of impetigo around her nose. She has recently been discharged from hospital following varicose vein surgery. Seven days after starting treatment there has been no change in her symptoms. Examination reveals a persistent small, crusted area around the right nostril.
Whilst awaiting the results of swabs, what is the most appropriate management?
Correct Answer D: MRSA should be considered given the recent hospital stay and lack of response to fusidic acid. Topical mupirocin is therefore the most appropriate treatment.
Impetigo: management: Limited, localized disease:
Extensive disease:
Café-au-lait spots are seen in each of the following, EXCEPT:
Correct Answer B: Hyperpigmented lesions that vary in colour from light brown to dark brown, with borders that may be smooth or irregular.
Café-au-lait spots
Causes:
Neurofibromatosis (NF1) Several larger (>1 cm) café-au-lait macules on the upper chest and multiple small macules on the axillae (axillary “freckling”) in a brown skinned female. Myriads of early, small, pink tan neurofibromas on the chest, breasts, and neck.
A 43-year-old presents with itchy lesions on the soles of both feet. These have been present for the past two months. On examination small blisters are seen with surrounding dry and cracked skin.
What is the most likely diagnosis?
Correct Answer C: Pompholyx is a type of eczema which affects both the hands (cheiropompholyx) and the feet (pedo-pompholyx). It is also known as dyshidrotic eczema.
Pompholyx Features:
Management:
Confluent vesicles of the palm.
Pompholyx eczema. (a) Small vesicles coalescing into blisters on the lateral aspect of a finger.
A 45-year-old woman is presents with itchy, violaceous papules on the flexor aspects of her wrists. She is normally fit and well and has not had a similar rash previously.
Given the likely diagnosis, what other feature is she most likely to have?
Correct Answer C: Mucous membrane involvement is common in lichen planus.
Lichen:
Lichen planus:
Lichen planus is a skin disorder of unknown aetiology, most probably being immune mediated.
Features:
Lichenoid drug eruptions - causes:
Lichen Planus Wrist.
Koebner phenomenon.
Lichen planus: reticulo-papular lesions in the common oral site, the buccal mucosa.
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