Derm

Question 1

Pemphigus vulgaris vs bullous pemphigoid

Answer 1

Pv - epidermis, blisters burst, oral lesions, dx with bx, pred is tx
Bp - dermis, less likely to rupture, dx with bx, tx is pred, more benign

Question 2

Basal cell carcinoma

Answer 2

Skin colored nodule with rolled borders, telangiectasias, can have local invasion, Mets rare

Dx with bx

Treat with excision, mobs, topicals as second line

Question 3

Fungal skin infection tx

Answer 3

Hair or nails go big guns - oral terbinafine, itra, or efinaconazole for many weeks, monitor lfts with terbinafine. Not systemic ketoconazole (liver tox and gynecomastia)

All else try topicals (eg ketoconazole, clotrimazole)

Question 4

Rosacea tx

Answer 4

Laser or pulsed light and topical brimonidine (alpha ag)

If papulopustular, topical metronidazole

Oral abx if severe

Question 5

Nec fasc tx

Answer 5

Surgical debridement (also for dx)
Then vanc or daptomycin, clinda, and beta lactam/beta lactamase (eg pip tazo) or carbapenem +/- ivig

Question 6

Desmoid tumor

Answer 6

Benign, locally recurrent, firm and deeply seated, often in abdome
Resect if symptomatic, also radiation if not surgical candidate

In mm or fascia
Seen in fap

Question 7

Dermatofibroma

Answer 7

Benign proliferation of fibroblasts, usu on extremities, often at site of trauma or insect bite

Question 8

Epidermoid cyst

Answer 8

Epidermal keratin lodged in dermis, usu on Ext, usu self resolves

Question 9

Pyogenic granuloma

Answer 9

Dome shaped, bleeding, capillary prolif after trauma esp in preg

Question 10

Ecthyma gangrenosum vs pyoderma gangrenosum

Answer 10

EG - psa, ulcerative skin lesions, usually in immunocomp, no pain
PG - neutrophilic dermatosis associated with IBd or arthritis, painful ulcers

Question 11

Most common bug causing cellulitis vs abscess

Answer 11

Cellulitis - strep pyogenes aka gas
Abscess - staph