Derm

Question 1

derm

Answer 1

Pityriasis versicolor presents in young adults as asymptomatic, oval-to-round, minimally scaly, hyperpigmented or hypopigmented macules that can coalesce into patches on the trunk and upper extremities.

Question 2

derm

Answer 2

The initial treatment for atopic dermatitis consists of good skin care with mild cleansers and thick emollients along with topical glucocorticoids to decrease inflammation and pruritus.

Question 3

derm

Answer 3

Skin biopsies should be performed to evaluate for urticarial vasculitis when individual urticarial lesions are present for longer than 24 hours.

Question 4

der,

Answer 4

Side effects from topical glucocorticoids include thinned skin, striae distensae (stretch marks), and easy bruising, and are likely to occur when they are used for extended periods of time, especially in skin folds or areas of occlusion.

Question 5

derm

Answer 5

Melanonychia is a longitudinal brown pigmentation of the nail plate; it can be a normal variant in persons with darker skin types, but it may also occur as a result of systemic disease, medication, infection, or an underlying melanocytic lesion.

Question 6

DERM

Answer 6

Low- to medium-potency topical glucocorticoids are first-line therapy for pruritic urticarial papules and plaques of pregnancy (PUPPP).

Question 7

DERM

Answer 7

Miliaria or “heat rash” can appear as superficial clear vesicles or as multiple discrete red papules due to the occlusion of eccrine sweat ducts.

Question 8

DERM

Answer 8

Isotretinoin is indicated for severe nodulocystic and recalcitrant acne; it is associated with severe birth defects and must be administered through the federal regulatory program iPLEDGE.

Question 8

DERM

Answer 8

Isotretinoin is indicated for severe nodulocystic and recalcitrant acne; it is associated with severe birth defects and must be administered through the federal regulatory program iPLEDGE.

Question 9

DERM

Answer 9

Amyopathic dermatomyositis presents with skin findings characteristic of dermatomyositis, but without clinical or laboratory evidence of muscle disease; it carries risks for underlying malignancy.

Question 10

DERM

Answer 10

Body surface area involvement is the strongest prognostic indicator in Stevens-Johnson syndrome/toxic epidermal necrosis (SJS/TEN).

SJS involves less than 10%, SJS-TEN overlap involves 10% to 30%, and TEN involves greater than 30%. TEN is almost exclusively caused by medications, whereas SJS can also be triggered uncommonly by vaccines or infection.

Question 11

DERM

Answer 11

Molluscum contagiosum is a common cutaneous viral infection that initially appears as firm, umbilicated flesh-colored to yellow papules; in adults it is considered a sexually transmitted infection that frequently involves the genital area.

Question 12

DERM

Answer 12

Pemphigus vulgaris is the most common intraepidermal ABD, and its incidence increases with age. It presents with oral and/or vaginal erosions and flaccid vesicles. Pemphigus vulgaris is associated with a positive Nikolsky sign whereby light friction on perilesional skin induces a blister.

Bullous pemphigoid is a chronic autoimmune blistering disease that predominantly affects elderly patients; it presents with urticarial plaques with tense bullae on the trunk and upper legs.

Question 13

DERM

Answer 13

A topical antibacterial agent, such as mupirocin, is the first-line therapy for localized impetigo.

Question 13

DERM

Answer 13

A topical antibacterial agent, such as mupirocin, is the first-line therapy for localized impetigo.

Question 14

DERM

Answer 14

Rheumatoid vasculitis typically occurs in elderly male smokers with long-standing rheumatoid arthritis and high titers of rheumatoid factor; it can appear as a small or medium-sized vasculitis and may affect nerves and other organs.

Question 15

BCC

Answer 15

Standard treatment for most basal cell carcinomas is wide local excision; however, some histologic types and body locations require more aggressive management. Biopsy prior to excision is important because the histopathologic diagnosis should be used to guide treatment.

Question 16

DERM

Answer 16

Basal cell carcinoma appears as asymptomatic translucent telangiectatic papules on sun-exposed areas in fair-skinned persons.

Question 17

DERM

Answer 17

Lupus pernio is sarcoidosis of the nose and central face, manifesting as violaceous subcutaneous plaques or nodules, often with some overlying scale.

Question 18

DERM

Answer 18

Lupus pernio is sarcoidosis of the nose and central face, manifesting as violaceous subcutaneous plaques or nodules, often with some overlying scale.

Question 19

DERM

Answer 19

Telogen effluvium is a generalized nonscarring alopecia triggered by a physically traumatic event such as surgery, parturition, or fever; it usually spontaneously resolves in about 6 to 12 months if the trigger is removed or treated.

Question 20

DERM

Answer 20

Transient acantholytic dermatosis is characterized by red pruritic papules on the chest, flanks, and back associated with dry skin, heat, and sweating.

Question 21

DERM

Answer 21

Drug reaction with eosinophilia and systemic symptoms (DRESS) can also present with erythroderma. This represents a delayed response to a medication several weeks after initiation. Patients present with rash, striking facial edema, peripheral eosinophilia (or less common atypical lymphocytosis), lymphadenopathy, and evidence of organ involvement such as acute kidney injury or abnormal liver chemistry tests.

Question 22

DERM

Answer 22

Calciphylaxis lesions are intensely painful, angulated, retiform purpuric patches with areas of black necrotic tissue that may form bullae, ulcerate, and leave a hard, firm eschar in patients with end-stage kidney disease.

Question 23

DERM

Answer 23

Primary treatment for abscess with no systemic signs of infection is incision and drainage; antibiotics should be added only if systemic symptoms or signs are present.

Question 24

DERM

Answer 24

Dapsone should be used in conjunction with a gluten-free diet as first-line treatment of dermatitis herpetiformis.

Question 25

DERM

Answer 25

Neomycin and bacitracin can cause allergic contact dermatitis that mimics a wound infection; the most appropriate initial management is to discontinue its use.

Question 26

DERM

Answer 26

Treatment of hand dermatitis includes topical emollients such as petrolatum to repair the skin barrier; hand washing should be minimized.