Derm Book Pictures - Exam 1

Question 1

What am I? What is the best tx?

Answer 1

comedones

upper arrow: white heads

lower arrow: black heads

topical retinoids

Question 2

What type of acne?

Answer 2

papulopustular acne

early stages of nodulocystic acne

Question 3

What am I?

Answer 3

Nodulocystic acne

Question 4

Answer 4

Acne conglobata In this severe nodulocystic acne, there are large confluent nodules and cysts forming linear mounds that correspond to interconnecting channels. There is pustulation, crusting, and scarring. Lesions are very painful.

Question 5

Answer 5

Acne conglobata on the trunk Inflammatory nodules and cysts have coalesced, forming abscesses that can lead to ulceration. There are many recent red scars following resolution of inflammatory lesions on the entire chest but also on the back

Question 6

Answer 6

Erythematous rosacea (stage I) The early stages of rosacea often present by episodic erythema, “flushing and blushing,” which is followed by persistent erythema caused by multiple tiny telangiectasias, resulting in a red face.

Question 7

Answer 7

Rosacea Moderate rosacea in a 29-year-old female with persistent erythema, telangiectasia, red papules (stage II), and tiny pustules

Question 8

Answer 8

Rosacea (stages II–III) Telangiectasia, papules and pustules, and some swelling in a 50-year-old woman. There are no comedones.

Question 9

Answer 9

Papulopustular rosacea (stage III) In this 68-year-old female, rosacea involves almost the entire face, sparing only the upper and lower lip and temples. Papules and pustules have coalesced—again no comedones—and have already led to some swelling of the cheeks, which present “solid” edema

Question 10

Answer 10

Rosacea (stage III) Here the persistent “solid” edema of the nose, forehead, and parts of the cheeks is the leading symptom. Papules, pustules, and crusted pustules are superimposed on this persistent edema. The enlarged nose feels rubbery and already represents rhinophyma. Note also blepharophyma of left upper eyelid

Question 11

Answer 11

Perioral dermatitis Moderate involvement with early confluence of tiny papules and a few pustules in a perioral distribution in a young woman. Note typical sparing of the vermilion border (mucocutaneous junction)

Question 12

Answer 12

Perioral dermatitis Preferential location around the mouth and nasolabial folds and cheeks. This 38-year-old woman has been treated with fluorinated corticosteroids that led to a worsening of the conditio

Question 13

Answer 13

Periorbital dermatitis Note presence of tiny papules and a few pustules around the eye. This is a much less common site than lesions around the mouth.

Question 14

Answer 14

Miliaria crystallina Tiny, superficial, clear vesicles on the trunk after excessive sweating

Question 15

Answer 15

Chromhidrosis Note blue to black droplets of lipofuscin stained apocrine sweat in the glandular duct orifices. There is also a bluish sheen imparted to the entire axillary skin by lipofuscin in the glands deeper down in the tissue

Question 16

Answer 16

Hidradenitis suppurativa Many black comedones, some of which are paired, are a characteristic finding associated with deep, exquisitely painful abscesses and old scars in the axilla

Question 17

Answer 17

Hidradenitis suppurativa Multiple bulging and depressed scars, draining sinuses and larger ulcer in the axilla of a 24-year-old male

Question 18

Answer 18

Hidradenitis suppurativa Severe scarring on the buttocks, inflammatory painful nodules with fistulas, and draining sinuses. When the patient sits down, pus will squirt from the sinus openings

Question 19

Answer 19

Hidradenitis suppurativa The entire perigenital and perianal skin as well as the buttocks and inner aspects of the thighs are involved in this 50-year-old male. There is considerable inflammation, and pressure releases purulent exudate from multiple sinuses. The patient had to wear a large diaper, because whenever he was seated, secretions would squirt from the sinuses

Question 20

Answer 20

macule, petechiae

Question 21

Answer 21

Patch, fixed drug eruption

Question 22

Answer 22

Papule, lichen nitidus

Question 23

Answer 23

Plaque, psoriasis.

Question 24

Answer 24

nodule, lymphoma cutis

Question 25

Answer 25

Vesicle, bullous lupus erythematosus. Note brown incipient crusts marking the sites of earlier blisters now ruptured

Question 26

Answer 26

Vesicles and bullae, linear IgA disease

Question 27

Answer 27

Pustule, pustular psoriasis

Question 28

Answer 28

Ichthyosiform scale, ichthyosis vulgaris

Question 29

Answer 29

Ostraceous scale, psoriasis

Question 30

Answer 30

Eschar overlying stellate purpura, calciphylaxis

Question 31

Answer 31

Lichenification, lichen simplex chronicus

Question 32

Answer 32

Purple papules, Kaposi sarcoma.

Question 33

Answer 33

Violaceous Gottron papules, dermatomyositis

Question 34

Answer 34

Apple-jelly sign, sarcoidosis

Question 35

Answer 35

Yellow, necrobiosis lipoidica diabeticorum.

Question 36

Answer 36

annular lesion, granuloma annulare

Question 37

Answer 37

Nummular lesion, nummular dermatitis.

Question 38

Answer 38

Reticular eruption, livedo racemosa

Question 39

Answer 39

Serpiginous erythema, jellyfish sting

Question 40

Answer 40

Atypical targetoid lesions, Stevens-Johnson syndrome due to medication.

Question 41

Answer 41

Polycyclic eruption, pityriasis rosea.

Question 42

Answer 42

Retiform purpura with ulceration and eschar, cutaneous polyarteritis nodosa.

Question 43

Answer 43

Urticarial phase, bullous pemphigoid.