1. A 5-year-old child presents with small, pearly, dome-shaped papules with central umbilication on the trunk. The mother is concerned about spread. What is the most appropriate advice?

• Reassure that the condition is self-limiting
• Prescribe topical antibiotics to prevent secondary infection
• Offer cryotherapy to remove the lesions
• Advise exclusion from school until lesions resolve

Answer: Reassure that the condition is self-limiting

Molluscum contagiosum is a benign viral infection that typically resolves spontaneously over months without intervention.

2. A 30-year-old woman spills hot tea on her forearm, resulting in redness and pain without blisters. What is the most appropriate initial management?

• Cool the burn with running water for at least 20 minutes
• Apply topical corticosteroids immediately
• Cover the burn with a dry dressing and monitor
• Debride the area to prevent infection

Answer: Cool the burn with running water for at least 20 minutes

Cooling a burn promptly limits tissue damage and alleviates pain. Further steps (dressing, analgesia) follow initial cooling.

3. A 40-year-old man presents with an itchy, raised rash appearing intermittently for the past week. He denies exposure to new foods or medications. What is the most likely cause?

• Idiopathic urticaria
• Food allergy
• Drug-induced hypersensitivity
• Insect bite reaction

Answer: Idiopathic urticaria

Chronic or recurrent urticaria is often idiopathic, especially without clear triggers or new exposures.

4. What is the underlying mechanism of lichen planus?

• T-cell mediated autoimmune response targeting keratinocytes
• Overactivation of sebaceous glands causing chronic inflammation
• Viral infection triggering epidermal hyperplasia
• Chronic irritation and scratching of the skin

Answer: T-cell mediated autoimmune response targeting keratinocytes

Lichen planus involves an inflammatory autoimmune process in which T lymphocytes attack the basal layer of the epidermis.

5. A 10-year-old boy presents with partial-thickness burns covering 12% of his total body surface area (TBSA). What is the most appropriate next step?

• Refer to a specialist burns unit
• Dress the wound with topical silver sulfadiazine
• Start prophylactic antibiotics
• Discharge with outpatient follow-up

Answer: Refer to a specialist burns unit

Paediatric burns exceeding 10% TBSA require specialist evaluation and management in a dedicated burns centre.

6. A 25-year-old woman presents with widespread blistering, mucosal involvement, and a targetoid rash after starting carbamazepine. What is the most appropriate next step?

• Admit to a burns unit for supportive care
• Prescribe high-dose systemic corticosteroids
• Start intravenous immunoglobulin (IVIG)
• Administer antihistamines for symptomatic relief

Answer: Admit to a burns unit for supportive care

SJS is an emergency requiring withdrawal of the offending agent and multidisciplinary supportive care in a specialised setting.

7. A 70-year-old woman presents with a painful ulcer on the medial malleolus. The surrounding skin is hyperpigmented, and she has pitting oedema. What is the most likely diagnosis?

• Venous leg ulcer
• Arterial ulcer
• Diabetic foot ulcer
• Pressure ulcer

Answer: Venous leg ulcer

Venous ulcers on the medial malleolus are associated with venous stasis, hyperpigmentation, and oedema.

8. What is the most effective strategy to prevent pressure ulcers in hospitalised patients?

• Repositioning every 2 hours and using pressure-relieving devices
• Applying topical antibiotics to prevent skin infection
• Providing high-protein dietary supplements
• Using barrier creams to prevent skin breakdown

Answer: Repositioning every 2 hours and using pressure-relieving devices

Frequent repositioning and special mattresses/cushions reduce pressure on susceptible areas, preventing ulcer formation.

9. A 40-year-old woman presents with an intensely itchy patch on her neck that she frequently scratches. Examination reveals a thickened, scaly plaque. What is the most appropriate treatment?

• High-potency topical corticosteroid
• Oral antihistamines
• Emollients and moisturisers
• UV phototherapy

Answer: High-potency topical corticosteroid

Lichen simplex chronicus (neurodermatitis) results from repeated scratching, requiring potent topical steroids to suppress inflammation and itch.

10. A 35-year-old man develops a widespread maculopapular rash 7 days after starting amoxicillin. He has no fever or systemic symptoms. What is the most likely diagnosis?

• Drug eruption
• Stevens-Johnson syndrome
• Toxic epidermal necrolysis (TEN)
• Urticaria

Answer: Drug eruption

Simple drug eruptions typically appear 1–2 weeks after starting a medication, presenting as a non-severe, maculopapular rash without significant systemic involvement.