Derm

Question 1

contact dermatitis –> type of hypersensitivity reaction?

Answer 1

type IV

Question 2

sulfa drug –> develop target shaped lesions on body including palms –> what condition?

Answer 2

erythema multiforme

Question 3

sulfa drug –> develop target shaped lesions on body including palms –> next step

Answer 3

remove drug –> watch & wait

Question 4

sulfa drug –> develop target shaped lesions on body including palms –> stopped sulfa –> rash is spreading –> what condition?

Answer 4

erythema multiforme progressing to Steven’s Johnson

Question 5

sulfa drug –> develop target shaped lesions on body including palms –> stopped sulfa –> now develop oral lesions –> what condition?

Answer 5

erythema multiforme progressing to Steven’s Johnson

Question 6

most common cause of erythema multiforme?

Answer 6

chronic HSV

Question 7

what is difference bw stevens johnson and toxic epidermal necrolysis?

Answer 7

SJS:

• <10% body surface area
• histology: basal cell degeneration

TEN:

• > 30% BSA
• histology: full thickness epidermal necrosis

Question 8

sulfa drug –> patient developed SJS –> next step

Answer 8

• stop ALL meds (including steroids)

- admit to burn unit

Question 9

how differentiate bw SJS/TEN and staph scalded skin syndrome?

Answer 9

• biopsy

- SSS: no mucosal involvement

Question 10

drug rash –> occurs how many days after start drug?

Answer 10

7-14 days

Question 11

targetoid lesion –> ddx (3)?

Answer 11

• erythema multiforme
• lyme disease
• syphilis

Question 12

most common drug classes that cause erythema multiforme/SJS/TEN (4)?

Answer 12

• sulfa
• PCN/cephalosporins
• anti-retrovirals
• anticonvulsants

Question 13

HSV is the MCC of erthyema multiforme –> what is another viral cause?

Answer 13

mycoplasma

Question 14

actinic keratosis –> tx?

Answer 14

cryoablation

Question 15

SCC –> spontaneously goes away –> what condition?

Answer 15

keratoacanthoma

Question 16

keratoacanthoma –> what does it look like?

Answer 16

resembles SCC –> solitary firm round nodule w central crater ulceration or keratin plug

Question 17

actinic keratosis –> what does it look like

Answer 17

adherent scale on erythematous base

Question 18

porphyria cutanea tarda –> most common in patients with history of what? (4)

Answer 18

• alcoholism
• HCV
• smoking
• estrogen use

Question 19

porphyria cutanea tarda –> common complication of disease

Answer 19

hemochromatosis

Question 20

porphyria cutanea tarda –> presentation

Answer 20

sun exposed area –> chronic blister –> fail to heal properly –> erosion, skin hyperpigment

Question 21

porphyria cutanea tarda –> management

Answer 21

avoid:
- sun
- alcohol
- excess iron

low dose antimalarial (ie hydroxychloroquine, chloroquine)

Question 22

pemphigus vulgaris vs bullous pemphigoid

Answer 22

pemphigus vulgaris:

• fragile blisters
• affect oral mucosa

bullous pemphigoid:
- tense blisters

Question 23

pemphigus vulgaris –> tx

Answer 23

oral prednisone

advjuvant: azthathioprine or cyclophosphamide

Question 24

39F –> axilla & genitalia –> vesicles, crusting erythematous plaques –> burning, pruritis, malodorous drainage

what condition?

Answer 24

familial benign pemphigus (aka Hailey-Hailey disease)

Question 25

58M –> trunk –> chronic papular eruption for 10 years duration –> itchy

What condition?

Answer 25

Grover disease (aka transient acantholytic dermatosis)