Dermatology

Question 1

Erythematous, scaly, palpable lesions overlying the MCP and intercarpal phalangeal joints

Answer 1

Grotton papules (dermatomyositis)

Question 2

Labial adhesion treatment

Answer 2

Estrogen topical BID => surgery

Question 3

Papulosquamous pruritic papules and plaques with purplish hue

Answer 3

Lichen planus (associated with Hepatitis C and drugs)

Question 4

Reddish-violaceous or bluish-purplish mottling in reticulated patches with a sharp demarcation at midline

Answer 4

Cutis marmorata telangiectatica congenita (vs. physiological cutis marmorata which improves with warming). Cutis = skin, marmorata = marbling, tel = end, angi = vessel, ectasia = dilation

Question 5

Erythematous indurated rash on cheeks in a well appearing asymptomatic child

Answer 5

Cold panniculitis

Question 6

Rash associated with Crohn’s disease

Answer 6

Erythema nodosum (Erythematous, tender, subcutaneous nodules on the extensor aspects of the legs between the knees and ankles)

Question 7

Diseases with erythema nodosum

Answer 7

Crohn’s disease, Behcet’s disease, bacterial gastroenteritis, strep throat, and disease with granulomas (TB, sarcoidosis, fungal)

Question 8

Rash with kwashiorkor

Answer 8

Flaky paint dermatosis (Blanching erythema with overlying reddish-brown scaling and sharply demarcated raised edges) vs acrodermatitis enterohepatica (Zinc deficiency)

Question 9

Pruritic and painful inflamed symmetrical vesicles/bullae on the palmar and lateral aspects of hands/feet

Answer 9

Dyshidrotic eczema (pompholyx)

Question 10

Alopecia areata treatment

Answer 10

1st line: Intralesional corticosteroids or potent topical steroid => 2nd line: systemic steroids => 3rd line: methotrexate or cyclosporin

Question 11

Newborn with vesicles and bullae with eosinophilia, and verrucous lesions (associations)

Answer 11

Incontinentia pigmenti (can have retinal detachment, strabismus)

Question 12

Sudden appearance of numerous small, discrete, drop-like, erythematous papules and plaques, some with fine scaly appearance, most prominent on the trunk and proximal extremities. Spares palms and soles. (Dz and association)

Answer 12

Guttate psoriasis, 80% patients have recent or current streptococcal infection (tonsillopharyngitis, perianal cellulitis, erysipelas)

Question 13

Widespread morbilliform rash that is particularly prominent on trunk, perineum, and intertriginous area (dz?)

Answer 13

Kawasaki disease

Question 14

A maculopapular rash associated with numerous petechiae involving the wrists, palms, ankles, and soles, and to a less extent, the trunk (dz?)

Answer 14

Rocky mountain spotted fever (remember hyponatremia and thrombocytopenia)

Question 15

Pruritic, reddish-brown macules and papules, which evolve into vesicular and necrotic lesions as new lesions appear, symmetrical, associated with fever and generalized malaise (dz and tx?)

Answer 15

Pityriasis lichenoides et varioliformis acuta (PLEVA) => last longer compared to VZV => tx erythromycin or UVB light therapy

Question 16

Dermatophytid reaction (id reaction). What is it and what is pathophys?

Answer 16

Autoeczematization during treatment for tinea infections => delayed type 4 hypersensitivity => symmetrical maculopapular/papulovesciular lesions on palms and side of fingers

Question 17

Term newborn with indurated, non-tender reddish nodules and plaques on posterior trunk, buttocks, cheeks, or bony prominence of extremity (diagnosis and tx)

Answer 17

Subcutaneous fat necrosis, monitor for hypercalcemia

Question 18

Young girl with 1 week of progressive vaginal itching, dysuria, and dyschezia. Symmetrical area of hypopigmentation around vulva and perianal skin associated with erythema, hemorrhagic erosions, small tears, and excoriations (dz and tx)

Answer 18

Lichen sclerosus, topical steroids