Blotches

Question 1

tinea versicolor pres

Answer 1

well demarcated tan or hypopigmented/hyper patches- usually trunk rarely face

spreads and more obvious in summer

scale seen when rubbed

Question 2

dx for tinea versicolor

Answer 2

KOH exam- can see short hyphae and small round spores of malassezia

Question 3

tx for tinea versicolor

Answer 3

anti dandruff shampoo

azole creams like ketoconazole

one time oral dose of fluconazole in widespread or recurrent

Question 4

recovery from tinea versicolor

Answer 4

scaling stops after days, pigment alteration takes weeks/months

Question 5

melasma pres

Answer 5

patchy light to dark brown pigmentation of face

usually women, called mask of pregnancy

occurs also w/ OCP and hormone replacement

Question 6

tx for melasma

Answer 6

sun avoidance, sunscreen at least spf 30

Question 7

minocycline pigmentation pres

Answer 7

brown or blue grey deposition after months or years

first noticed on alveolar ridge, palate, sclear

Question 8

other meds w/ discoloration

Answer 8

amiodarone, antimalarials like hydroxychloroquine

Question 9

stasis dermatitis pres

Answer 9

eczematous eruption w/ venous insuffieciency and leg edema

can be confused w/ cellulitis

extravasation leads to brown pigment/ petechiae

can have ulcers

Question 10

tx for stasis dermatitis

Answer 10

reduce edema: elevation and compression

mid potency topicals

avoid topical abx, want to avoid allergic contact dermatitis (esp neomycin and bacitracin)

Question 11

what is post inflammatory hyperpigmentation

Answer 11

darkening of skin at or around sites of injury- darker complexion at higher risk

Question 12

dx of vitiligo

Answer 12

bright white depigmentation w/ woods light

Question 13

etiology of vitiligo

Answer 13

autoimmune attack on melanocytes

Question 14

favored vitiligo sites

Answer 14

areas of trauma- knees, elbows, etc

Question 15

assoc w/ vitiligo

Answer 15

w/ other autoimmune disorders

Question 16

tx for vitiligo

Answer 16

potent topicals or tacrolimus ointment

phototherapy w/ narrow band UVB

Question 17

steroid hypopigmentation

Answer 17

skin lightening, higher risk in dark skin types

Question 18

gene linked to dyskeratosis congenita

Answer 18

DKC1 is most common, x linked recessive

Question 19

signs of dyskeratosis congenita

Answer 19

reticulate dyspigmentation, premature aging, nail dystrophy, oral leukoplakia

Question 20

4 common light rashes

Answer 20

vitiligo
tinea versicolor
seb derm
pityriasis alba (mild atopic derm)