Dermatology Cases – KFP public report review 2016-2024 topics in exam

Key Medical Topics in Dermatology Cases

1. Skin Cancer Management

• Melanoma Management
  • Key Topics:
    • Diagnosis and management of melanoma, including biopsy interpretation and appropriate margin width.
    • Patient education about ongoing care and skin cancer prevention.
    • End-of-life care for metastatic disease.
  • Common Errors:
    • Non-specific description of local excision without specifying margin width.
    • Inappropriate intervals for skin examination checks.
    • Overemphasis on sun protection at the expense of other skin cancer education.
    • Overcoding by providing more answers than requested in end-of-life care.
• Lentigo Maligna
  • Key Topics:
    • Timely and specific diagnosis and management of skin cancers.
    • Importance of urgent excisional biopsy.
  • Strengths:
    • Identifying urgent management strategies for potential malignancies.
  • Improvements:
    • Enhance understanding of patient-physician relationship dynamics, especially after diagnostic or therapeutic challenges.
• New Mole and Keloid Scar
  • Key Topics:
    • Clinical assessment of a mole.
    • Management of keloid scars.
    • Handling patient complaints.
  • Candidate Performance:
    • Failure to address specific dermatological conditions.
  • Improvement Areas:
    • Dermatological assessment skills.
    • Keloid scar management.
    • Effective communication strategies.
• Pigmented Lesion Assessment
  • Key Topics:
    • Evaluation and management of changing pigmented lesions using frameworks like ABCDE or Glasgow.
  • Candidates Did Well On:
    • Using frameworks for assessment.
  • Improvement Areas:
    • Mentioning biopsy or histopathology with excision.
    • Ensuring histology for medico-legal reasons.

2. Inflammatory Skin Conditions

• Severe Facial Acne and Online Bullying
  • Key Topics:
    • Effective acne management considering patient history and contraindications.
    • Addressing psychological impacts like online bullying.
  • Strengths:
    • Specific actionable advice for acne treatment and managing bullying.
  • Improvements:
    • Understanding contraindications and side effects in acne pharmacotherapy.
• Severe Rosacea
  • Key Topics:
    • Balanced approach including pharmacological and non-pharmacological treatments.
    • Considering condition’s impact on the patient’s quality of life.
  • Specifics:
    • Focusing on pharmacological treatments without holistic management.
  • Improvement Areas:
    • Emphasizing holistic management approaches and patient education on trigger avoidance.
• Acne and Facial Palsy
  • Key Topics:
    • Management of resistant acne.
    • Identification and management of facial palsy.
  • Candidate Performance:
    • Incorrect management choices for acne.
    • Failure to provide specific Bell’s palsy management.
  • Improvement Areas:
    • Tailored acne treatments.
    • Immediate and specific management for facial palsy.

3. Dermatological Infections

• Hand, Foot, and Mouth Disease & Pyogenic Granuloma
  • Key Topics:
    • Diagnosis of primary conditions.
  • Strengths:
    • Diagnosis of primary conditions.
  • Improvements Needed:
    • Offering appropriate non-pharmacological advice.
    • Avoiding unnecessary pharmacological management.
• Dermatomycosis and Breast Swelling
  • Key Topics:
    • Fungal infections.
    • Normal pubertal changes.
  • Candidates Did Well On:
    • Identifying fungal infection management and normal pubertal breast changes.
  • Improvement Areas:
    • Avoiding over-investigation for normal pubertal changes.
    • Focusing on education and reassurance.
• Tinea Cruris and Herpes Zoster
  • Key Topics:
    • Identification of the rash.
    • Understanding underlying conditions predisposing to tinea cruris.
    • Distinguishing between herpes zoster and genital herpes treatments.
  • Specifics:
    • Identifying the rash well.
    • Challenges in distinguishing between treatments.
  • Improvement Areas:
    • Deepening knowledge on conditions predisposing to dermatological issues.
    • Ensuring treatment plans are specific to the diagnosed condition.

4. Allergic and Irritant Dermatitis

• Allergic Contact Dermatitis
  • Key Topics:
    • Differential diagnosis and management of contact dermatitis.
  • Specifics:
    • Common misdiagnoses.
  • Improvement Areas:
    • Sharpening diagnostic skills to distinguish between contact dermatitis and other skin conditions.
    • Detailed treatment plans including steroid potency and application frequency.

5. Chronic and Recurrent Dermatological Conditions

• Exacerbation of a Chronic Dermatological Condition
  • Key Topics:
    • Consideration of exacerbating factors for a long-standing rash.
    • Focus on topical pharmacological management and diagnostic investigations.
  • Candidate Performance:
    • Errors in suggesting oral medications.
    • Mentioning irrelevant exacerbating factors.
  • Improvement Areas:
    • Focus on relevant topical treatments.
    • Align management suggestions with the case specifics.
• Guttate Psoriasis
  • Key Topics:
    • Diagnosis and management of guttate psoriasis.
  • Candidates Did Well On:
    • Correctly identifying guttate psoriasis.
  • Improvement Areas:
    • Addressing psoriasis directly.
    • Emollients vs. specific psoriasis management.
    • Precise usage of topical steroids.

6. Miscellaneous Dermatological Conditions

• Scalp Itch and Hair Loss
  • Key Topics:
    • Differential diagnoses for scalp itch and hair loss.
    • Initial pharmacological management of scalp psoriasis.
    • Non-pharmacological management advice.
  • Common Errors:
    • Not recognizing appropriate formulation of topical therapy for the scalp.
    • Lack of awareness of best practice guidelines.
• Photodermatitis
  • Key Topics:
    • Differential diagnosis and management of photodermatitis.
    • Long-term sun damage management.
  • Candidate Performance:
    • Misidentification of presentation.
    • Inadequate specific management strategies.
  • Improvement Areas:
    • Specific management excluding sunscreen.
    • Long-term sun damage care.
• Malodorous Feet
  • Key Topics:
    • Diagnosis of foot conditions.
    • Pharmacological and lifestyle management.
  • Candidate Performance:
    • Overcoding and providing excessive, irrelevant answers.
  • Improvement Areas:
    • Provide concise, relevant pharmacological treatments and practical lifestyle modifications.
• Bald Patch Management in an Elderly Man
  • Key Topics:
    • History taking.
    • Diagnosis.
    • Topical management.
  • Candidate Performance:
    • General responses, inadequate management suggestions.
  • Improvement Areas:
    • Tailored history taking.
    • Specific topical treatment options.

7. Pediatric Dermatology

• Pediatric Dermatology in an Aboriginal Child
  • Key Topics:
    • Diagnosis and management of a new itchy rash.
    • Non-pharmacological and pharmacological strategies.
  • Candidate Performance:
    • Lack of tailored educational responses.
  • Improvement Areas:
    • Provide culturally sensitive education and management plans.

8. Emergency Dermatology

• Acute Desquamation Presentation
  • Medical Heading: Dermatology, Emergency Medicine.
  • Key Topics:
    • Diagnosis of acute skin reactions.
    • Urgent supportive treatment.
    • Differential considerations.
  • Candidate Performance:
    • Well-identified diagnosis.
    • Some confusion over immediate management priorities.
  • Improvements Areas:
    • Focus on emergency management of severe dermatological reactions.
    • Emphasizing rapid supportive care and specific treatment modalities.

9. Dermatological Oncology

• Oncology and Dermatology: Rapidly Developing Facial Lesion
  • Key Topics:
    • Diagnosis and management of facial lesions.
    • Patient communication about sequelae.
  • Candidate Performance:
    • General responses without addressing specific patient concerns.
  • Improvement Areas:
    • Specific diagnosis and management of skin lesions.
    • Effective communication of potential outcomes.