A 24-year-old woman presents due to a rash on her neck and forehead. She returned from a holiday in Cyprus 1 week ago and had her hair dyed 2 days ago. On examination there is a weepy, vesicular rash around her hairline although the scalp itself is not badly affected.
What is the most likely diagnosis?
Correct Answer C:
Contact dermatitis: There are two main types of contact dermatitis:
Cement is a frequent cause of contact dermatitis. The alkaline nature of cement may cause an irritant contact dermatitis whilst the dichromates in cement also can cause an allergic contact dermatitis.
Acute allergic contact dermatitis in a patient allergic to acrylates used in the printing industry.
Which of the following conditions is least likely to exhibit the Koebner phenomenon?
Correct Answer E: Lupus vulgaris is not associated with the Koebner phenomenon.
Koebner phenomenon: The Koebner phenomenon describes skin lesions which appear at the site of injury. It is seen in:
Koebner phenomenon. Psoriasis appearing in the line of a scratch.
A 21-year-old woman who is 16 weeks pregnant present with worsening acne which she is finding distressing. She is currently using topical benzyl peroxide with limited effect. On examination there is widespread noninflammatory lesions and pustules on her face.
What is the most appropriate next management step?
Correct Answer C: Oral erythromycin may be used for acne in pregnancy. The other drugs are contraindicated.
Acne vulgaris: management: Acne vulgaris is a common skin disorder which usually occurs in adolescence. It typically affects the face, neck and upper trunk and is characterized by the obstruction of the pilosebaceous follicles with keratin plugs which results in comedones, inflammation and pustules.
Acne may be classified into mild, moderate or severe:
A simple step-up management scheme often used in the treatment of acne is as follows:
There is no role for dietary modification in patients with acne.
Postinflammatory macules and pigment changes interspersed with inflammatory acne.
Which one of the following factors would predispose a patient to forming keloid scars?
Correct Answer C: Keloid scars - more common in young, black, male adults.
Keloid scars: Keloid scars are tumour-like lesions that arise from the connective tissue of a scar and extend beyond the dimensions of the original wound.
Predisposing factors:
Treatment:
*Langer lines were historically used to determine the optimal incision line. They were based on procedures done on cadavers but have been shown to produce worse cosmetic results than when following skin tension lines.
Earlobe keloid
A 49-year-old man is reviewed in the dermatology clinic complaining of losing hair. Examination reveals generalized scalp hair loss that does not follow the typical male-pattern distribution.
Which one of the following medications is least likely to be responsible?
Correct Answer E: Phenytoin is a recognized cause of hirsutism, rather than alopecia .
Alopecia:
Alopecia may be divided into scarring (destruction of hair follicle) and non-scarring (preservation of hair follicle).
Scarring alopecia:
Non-scarring alopecia:
*scarring would develop in untreated tinea capitis if a kerion develops.
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