A 19-year-old student presents with a three day history of a 1 cm golden, crusted lesion on the border

of her lower lip. What is the most suitable management? Impetigo

A. Oral co-amoxiclav

B. Oral penicillin

C. Oral flucloxacillin

D. Oral flucloxacillin + penicillin

E. Topical fusidic acid

A 25-year-old man presents with a widespread rash over his body. The torso and limbs are covered
with multiple erythematous lesions less than 1 cm in diameter which in parts are covered by a fine
scale. You note that two weeks earlier he was seen with a sore throat when it was noted that he had
exudative tonsillitis. Other than a history of asthma he is normally fit and well. What is the most likely
diagnosis?

A. Pityriasis rosea

B. Pityriasis versicolor

C. Syphilis

D. Discoid eczema

E. Guttate psoriasis(similar to p.rosea,so D.D with these features)

Each one of the following is associated with yellow nail syndrome except:

A. Chronic sinus infections

B. Bronchiectasis

C. Azoospermia

D. Congenital lymphoedema

E. Pleural effusions

A 54-year-old man with significant psoriasis and related arthritis comes to the rheumatology clinic for
review. despite both NSAIDs and corticosteroids, his symptoms continue to worsen. On examination
you can see both extensive plaque psoriasis, and deforming polyarthropathy leading to significant loss
of function affecting both hands.

Investigations

Hb 123 g/l Na+ 140 mmol/l Platelets 321 * 109/l K+ 4.2 mmol/l

WBC 10.1 * 109/l Urea 6.7 mmol/l Neuts 6.1 * 109/l Creatinine 105 μmol/l

Lymphs 1.9 * 109/l CRP 104 mg/l Eosin # * 109/l ESR 70 mm/hr

Which of the following is the most appropriate next step? Uncontrolled psoriasis

A. Azathioprine

B. Brodalumab

C. Etanercept ( un controlled Psoryis )

D. Rituximab (uncontrolled R.A)

E. Toclizumab
A 17-year-old man presents with a 2 week history of abdominal pain, diarrhoea and repeated episodes
of flushing. Examination reveals urticarial skin lesions on the trunk. What test is most likely to reveal
the diagnosis?

A. Chest x-ray

B. Urinary catecholamines

C. Serum amylase

D. Urinary 5-HIAA

E. Urinary histamine

A 20-year-old man presents with acute gingivitis associated with oral ulceration. A diagnosis of
primary herpes simplex infection is suspected. Which one of the following types of rash is he most
likely to go an develop?

A. Erythema ab igne

B. Erythema nodosum

C. Erythema chronicum migrans

D. Erythema marginatum

E. Erythema multiforme

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?

A. Oral vancomycin

B. Oral erythromycin

C. Topical metronidazole

D. Topical mupirocin

E. Oral flucloxacillin

A 25-year-old man presents with a pruritic skin rash. This has been present for the past few weeks and
has responded poorly to an emollient cream. The pruritus is described as 'intense' and has resulted in
him having trouble sleeping. On inspecting the skin you notice a combination of papules and vesicles
on his buttocks and the extensor aspect of the knees and elbows. What is the most likely diagnosis?

A. Lichen planus

B. Chronic plaque psoriasis

C. Henoch-Schonlein purpura

D. Dermatitis herpetiformis

E. Scabies

Pellagra is caused by a deficiency in:

A. Vitamin B12
 B. Thiamine

C. Nicotinic acid

D. Vitamin B2

E. Vitamin B6

A 17-year-old male is reviewed six weeks after starting an oral antibiotic for acne vulgaris. He stopped
taking the drug two weeks ago due to perceived alteration in his skin colour, and denies been exposed
to strong sunlight for the past six months. On examination he has generalised increased skin
pigmentation, including around the buttocks. Which one of the following antibiotics was he likely to
be taking?

A. Doxycycline

B. Oxytetracycline

C. Tetracycline

D. Erythromycin

E. Minocycline

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 non-inflammatory lesions and pustules on her face. What is the most appropriate next
management step?

A. Oral trimethoprim

B. Oral lymecycline

C. Oral erythromycin

D. Topical retinoid

E. Oral doxycycline

A 50-year-old man with a history of ulcerative colitis comes for review. Six years ago he had an
ileostomy formed which has been functioning well until now. Unfortunately he is currently suffering
significant pain around the stoma site. On examination a deep erythematous ulcer is noted with a
ragged edge. The surrounding skin is erythematous and swollen. What is the most likely diagnosis?
 A. Munchausen's syndrome

B. Irritant contact dermatitis

C. Pyoderma gangrenosum

D. Dermatitis artefacta

E. Stomal granuloma

Which one of the following factors would predispose a patient to forming keloid scars?

A. Having white skin

B. Incisions along relaxed skin tension lines

C. Being aged 20-40 years

D. Being female

E. Having a wound on the lower back

A 22-year-old male sex worker comes to the Emergency department with an erythematous skin rash.
He tells you that it began on his scalp, and is now spreading to involve his face, neck, and the flexor
surfaces of his arms and legs. He has no significant past medical history and takes no regular
medication. Blood pressure, pulse and temperature are all normal. Respiratory and abdominal
examination is unremarkable. There are extensive erythematous scaly plaques, the overlying skin is
greasy and there are areas of yellow / brown crusted material.

Which of the following tests is most important in this situation?

A. Autoimmune profile

B. Herpes PCR

C. HIV testing

D. Skin scrapings for microscopy and culture

E. Syphilis serology

A 26-year-old lady presents to you distressed due to the presence of a rash over her thorax and
abdomen for the last three weeks. On examination, you note numerous teardrop lesions on her body.

She has no known past medical history and denies exposure to any new irritants. She states that she is
going to be married in 2 weeks and wants to know if there is anything that can be done to hasten the
disappearance of her rash.
Which therapy could this lady be commenced on?

A. Photochemotherapy (PUVA) A

B. Oral prednisolone

C. Dermovate

D. Ultraviolet B phototherapy

E. Methotrexate

An 84-year-old woman with a history of ischaemic heart disease is reviewed in the dermatology clinic.
Her current medication includes aspirin, simvastatin, bisoprolol, ramipril and isosorbide mononitrate.
She has developed tense blistering lesions on her legs. Each lesion is around 1 to 3 cm in diameter and
she reports that they are slightly pruritic. Examination of her mouth and vulva is unremarkable. What
is the most likely diagnosis?

A. Pemphigus

B. Drug reaction to aspirin

C. Epidermolysis bullosa

D. Scabies

E. Bullous pemphigoid

A 52-year-old African-American woman presents to the dermatology department. She has noticed a
patch of pigmented skin on her toe, which has been slowly enlarging over the past five months. On
examination, she has pigmentation of the nail bed of her great toe, affecting the adjacent cuticle and
proximal nail fold. Which subtype of melanoma would you expect to present in this manner?

A. Superficial spreading melanoma

 B. Acral lentiginous melanoma

C. Lentigo maligna melanoma

D. Nodular melanoma

E. Amelanotic melanoma

Which one of the following side-effects is least recognised in patients taking isotretinoin?

A. Hypertension

B. Teratogenicity

C. Nose bleeds

D. Depression

E. Raised triglycerides

Each one of the following is associated with hypertrichosis, except:

A. Anorexia nervosa

B. Porphyria cutanea tarda

C. Psoriasis

D. Minoxidil

E. Ciclosporin

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?

A. Cutaneous leishmaniasis

B. Irritant contact dermatitis

C. Allergic contact dermatitis

D. Syphilis

E. Photocontact dermatitis