Dermatology

Question 1

Pustules of erythema toxicum contain

Answer 1

Eosinophils (reassurance)

Question 2

Pustules of transient neonatal pustular melanosis contain

Answer 2

Neutrophils (reassurance)

Question 3

Newborn with white papules on the hard palate

Answer 3

Epstein pearls (reassurance)

Question 4

Newborn with pinhead white papules on the face

Answer 4

Milia (reassurance)

Question 5

Newborn with white papules on the upper gums

Answer 5

Bohn nodules (reassurance)

Question 6

An infant with small papules and pustules on the forehead, nose, and cheeks and an absence of comedones.

Answer 6

Neonatal acne (resolves without treatment)

Question 7

Newborn with blistering and erosions of the skin. May have mucous membrane and nail involvement. Infection has been ruled out

Answer 7

Epidermolysis bullosa

Question 8

What is the best diagnostic test for epidermolysis bullosa?

Answer 8

Skin biopsy of an induced blister or genetic testing

Question 9

Well-defined erythematous plaques on the knees and elbows, covered with silvery scales, bleed when removed, pitting of the nails

Answer 9

Psoriasis

Question 10

Child with ulcerative colitis presents with bright red, tender nodules on the anterior leg

Answer 10

Erythema nodosum

Question 11

Erythematous, scaly plaques in periorificial and acral areas, alopecia, and diarrhea

Answer 11

Acrodermatitis enteropathica (zinc deficiency)

Question 12

A 2-year-old boy with fever, fragile blisters, and denuded skin, predominantly affecting the flexures and perioral skin

Answer 12

Staph scalded skin syndrome (SSSS)

Question 13

Adolescent boy with a history of cold sores presents with targetoid papules, distributed acrally, and hemorrhagic crusting of the lips

Answer 13

Erythema multiforme

Question 14

Child is taking penicillin for a dental abscess, developed macules, papules, vesicles, bullae, and ulcerations on 8% of the body surface area. Sloughing, blistering, and ulceration around the lips, eyes, and genitalia are also present

Answer 14

Stevens–Johnson syndrome

Question 15

Most common virus that triggers erythema multiforme

Answer 15

Herpes simplex virus (HSV)

Question 16

Poorly defined, hypopigmented rough macules and patches on the cheeks

Answer 16

Pityriasis alba

Question 17

Adolescent with oval scaly papules and plaques on the trunk that run parallel to skin cleavage lines

Answer 17

Pityriasis rosea

Question 18

Adolescent boy with hypopigmented scaly lesions on the neck, chest, and back that worsen with sun exposure

Answer 18

Tinea versicolor

Question 19

What is the cause of tinea versicolor?

Answer 19

Malassezia furfur

Question 20

Child with an itchy rash affecting both feet. Exam shows scaling, fissuring, and maceration in the interdigital spaces. What is the best treatment?

Answer 20

Topical antifungal cream, e.g., terbinafine cream

Question 21

Child with one bald spot on the scalp with scale and “black-dot” hairs (the remnants of broken hairs within follicles). What is the best treatment?

Answer 21

Oral antifungal

Question 22

Child with one bald spot on the scalp with no associated scale or redness. What is the best treatment?

Answer 22

Reassurance or topical steroids (alopecia areata)

Question 23

A young child with diffuse thinning of the hair on the scalp after undergoing major surgery 3months prior

Answer 23

Telogen effluvium

Question 24

Condition with pegged-shaped teeth, prominent ears, small chin, frontal bossing, absence of sweating with associated overheating

Answer 24

Hypohidrotic ectodermal dysplasia

Question 25

Female neonate with blistering and/or hyperpigmentation of the skin in a blaschkoid distribution. May be associated with eye and neurologic abnormalities

Answer 25

Incontinentia pigmenti (X-linked dominant)

Question 26

Fish-like scaling of the body, sparing flexural areas, with corneal opacities and history of cryptorchidism

Answer 26

X-linked recessive ichthyosis

Question 27

Extremities are covered with fine, irregular, polygonal scales, hyperlinear palms; worse with dry weather and during winter, family history of “dry skin”

Answer 27

Ichthyosis vulgaris

Question 28

Erythematous, scaly, itchy plaques in the antecubital and popliteal fossae, older brother with asthma

Answer 28

Atopic dermatitis

Question 29

A 3-year-old boy was exposed to poison ivy while playing in the garden. He developed itchy linear streaks of vesicles on both arms. What is the best treatment?

Answer 29

Topical steroids (Rhus dermatitis)

Question 30

What is the most important recommendation for all cases of contact dermatitis?

Answer 30

Avoidance of triggering agents

Question 31

Folliculocentric papules with central keratinous debris on the upper arms and thighs

Answer 31

Keratosis pilaris

Question 32

Unilateral, irregular brown to blue-gray pigmentation of the neck, shoulder, supraclavicular, deltoid, and/or upper arm skin. May darken at puberty

Answer 32

Nevus of Ito

Question 33

Unilateral, irregular, blue-gray discoloration in the periorbital area and sclera (Ocular)

Answer 33

Nevus of Ota

Question 34

A nevus of Ota involving the sclera requires monitoring by ophthalmology due to increased risk of

Answer 34

Glaucoma > ocular melanoma

Question 35

Large congenital nevi likely carry an increased risk of what type of cancer?

Answer 35

Melanoma

Question 36

Child is going to the beach for swimming and parents are concerned about sunburn. How would you counsel the family about sunscreen use?

Answer 36

Apply SPF 30 or greater sunscreen 15–30 min before sun exposure, reapply every 2 h

Question 37

Large facial port-wine stain involving V1, seizures, and glaucoma

Answer 37

Sturge–Weber syndrome

Question 38

Posterior fossa malformations (Dandy–Walker), hemangiomas, arterial anomalies, cardiac defects (e.g., coarctation of the aorta), and eye abnormalities

Answer 38

PHACE syndrome

Question 39

An infant with a large hemangioma on the upper eyelid is at risk for

Answer 39

Amblyopia

Question 40

What is the best treatment for a hemangioma on the upper eyelid that obstructs the visual axis?

Answer 40

Oral propranolol

Question 41

Annular plaque without scale not responding to topical antifungals

Answer 41

Granuloma annulare

Question 42

An infant with orange to brown macules and papules that become red and swollen when stroked

Answer 42

Urticaria pigmentosa (cutaneous mastocytosis)

Question 43

An infant with a 4-month history of seborrheic dermatitis-like rash on the scalp, behind the ears, and in the diaper area not responsive to topical antifungals or steroid cream

Answer 43

Langerhans cell histiocytosis

Question 44

A 12-year-old boy with learning disabilities and seizure disorder presents with persistent papules on the face despite acne treatment. He is also found to have hypopigmented skin lesions on the exam

Answer 44

Tuberous sclerosis

Question 45

A 10-month-old with light brown macules and small patches on the body. How many café-au-lait macules should raise concern for neurofibromatosis?

Answer 45

Six

Question 46

What is the treatment for head lice?

Answer 46

Permethrin 1% liquid; 2 treatments spaced 1 week apart

Question 47

What is the treatment for scabies?

Answer 47

Permethrin 5% cream; 2 treatments spaced 1 week apart