Derm

Question 1

Porphyria cutanea tarda

Answer 1

Fragile, photosensitive skin that develops bullae and vesicles after trauma or sun exposure. These will heal as either hyper or hypo pigmented scars.
Tx: phlebotomy or hydroxychloroquine
Strong association with HepC

Question 2

Bullous Pemphigoid

Answer 2

Autoimmune, severe pruritis and tense bullae on an erythematous base. Most common in people over the age of 65 who also have an underlying malignancy or neurologic disease (MS, Parkinsons, etc)

Autoantibodies against hemidesmosomes and basement membrane. Linear IgG and C3 deposits on immunofluorescence.

Tx: High Dose topical steroids (clobetasol)

Question 3

Ringworm description

Answer 3

pruritic, scaly rash, with central clearing and raised annular border.

Question 4

Pityriasis rosea

Answer 4

Herald patch (annular, pink) followed by a Christmas tree pattern (macules and papules). Viral prodrome. May or may not have pruritis.

Tx: Reassurance/antihistamine for itching.

Question 5

Necrolytic Migratory Erythema

Answer 5

Papules or plaques with central clearing, crusting, erosion on borders that occur on the face, limbs, perineum. Occurs with glucagonoma.

Question 6

Basal Cell Carcinoma

Answer 6

Ulcerated, pearly nodule, rolled border on sun-exposed skin. Most common skin cancer. Can be pink, red, or white.

Question 7

Tx of Basal Cell Carcinoma

Answer 7

Lesion on face: Moh’s surgery

Lesion not on face: Excision with 3-5mm margins.

Question 8

Pellagra

Answer 8

Dermatitis, Diarrhea, Dementia

Lack of Niacin (synthesized from tryptophan)
Isoniazid toxicity, vegans

Question 9

SCC of the skin

Answer 9

most common malignancy of the lip

Question 10

congenital melanocytic nevus

Answer 10

a large mole with increased hair follicles.

Question 11

Dermatitis herpetiform

Answer 11

a vesicular rash over the extensor surfaces commonly associated with Celiac Disease

Question 12

Frostbite tx

Answer 12

Rapid rewarming in a warm water bath

Thrombolysis in limb-threatening conditions

Question 13

Skin findings associated with Pseudomonas infx

Answer 13

Ecthyma gangrenosum

An ulcer that rapidly progresses to necrotic nodule

Question 14

Bullous pemphigoid

Answer 14

Found in elderly
Bullae and itching
Subepidermal cleavage with linear IgG deposits along the basement membrane

Question 15

Pemphigous Vulgaris

Answer 15

Intraepidermal cleavage involving the desmosomes
acanthosis
skin is very fragile

Question 16

Condyloma acuminata vs lata

Answer 16

acuminata are caused by HSV, tend to be verrucous and friable

lata are caused by secondary syphilis and tend to be smooth and broad based.

Question 17

Perifollicular hemorrhage

Answer 17

Scurvy