Derm

Question 1

not palm/soles, friction can alter, Leser may mean malig; remove w/ cryo or electrodessication vs looks like seb keratoses but darker skin, remove for cosmetics

Answer 1

seb keratoses vs dermatosis papulosa nigra

Question 2

hyperplasia stratum spinosum, could be sign of stomach ca if no comorbid; tx underlying, topical NH4 lactate or retinoids. 3ad for stomach ca? lung ca?

Answer 2

acanthosis nigrans. that + acanthosa palmaris + Leser. acanthosa palmaris

Question 3

yellow papules w/ central umbilication vs benign sweat duct tumor

Answer 3

seb hyperplasia vs syringoma

Question 4

epidermoid cyst vs pilar cyst

Answer 4

ear/face/neck/chest, hair follicle or epith w/ central punctum, inflam if cyst leaks; tx w/ incision & evac vs scalp, hair root sheath w/o punctum; tx w/ incision & evac

Question 5

from skin injury -> fib, dimple sign vs healing w/ margins & regress vs healing beyond margins & not regress -> tx w/ steroid inject, excision, destruction

Answer 5

dermatofib vs hypertrophic scar vs keloid

Question 6

rapidly growing dome & scaly base that bleed easily. tx w/ watchful wait, involute, electrocautery

Answer 6

pyogenic granuloma

Question 7

tx lesion vs field directed AK

Answer 7

cryo, PDT, laser, surg vs 5FU, PDT, imiquod, ingenol, diclofenac

Question 8

from UVB, North Euro, nodular/superficial/pig/morpheaform, bone/tissue, rolled pearly border; tx w/ excision, Moh’s vs arsenic, transplant; invasion, tx w/ excision, Moh’s, rads

Answer 8

BCC vs SCC

Question 9

amelanotic vs desmoplastic. How far does Clark lvl apply?

Answer 9

any melanoma -> bx vs head/neck, sclerotic, indurated, invade deeply but low rate LN mets. up to 1mm

Question 10

local vs in transit vs nodal vs hematogenous mets melanoma. when to do sentinel node bx?

Answer 10

w/in 2cm vs >2cm vs into regional LN via lymphatic system vs into blood vessels via bloodstream -> distant sites. >stage IB, <0.8 w ulcer, >0.8 wwo ulcer

Question 11

causes of acne vulgaris vs triggers for rosacea

Answer 11

inflam piloseb unit, hyperkeratinization follicles, sebum, P acnes vs alc, hot, sun, stress/exer, irritation from skin products

Question 12

tx vs complications atopic dermatitis/eczema

Answer 12

avoid, emollient, moisturize, calcineurin inhib, glucocorticoids, PDE4I, phototherapy; antihist vs staph -> mupirocin, eczema herpeticum -> bleach baths, valacyclovir