Dermatology

Question 1

[Derm/Neonate]

Neonatal acne vs infantile acne

First 2-4 weeks of life
No comedones
No treatment

Answer 1

Neonatal acne

Question 2

[Derm/Neonate]

Neonatal acne vs infantile acne

At 2-4 months of life
Androgenic effects on the sebaceous glands
Comedones
Topical retinoids, benzoyl peroxide (can leave scar)

Answer 2

Infantile ance

Question 3

[Derm/Vascular]

Diagnosis?

Fixed, reticulated, pink-violaceous vascular patches (not changed with warming)
50% associated with lib hypo/hyperplasia
Ophthalmologic abnormalities

Answer 3

Cutis Marmorata Telangiectatica Congenita

Question 4

[Derm/pigmented]

Diagnosis?
Management in pediatrics and adult?

A hamartoma of sebaceous glands

Answer 4

Nevus Sebaceous

• Management:
  in children - monitoring
  in adult - elective excision (malignancy potential)

Question 5

[Derm/pigmented]

Diagnosis?

Answer 5

Nevus Spilus
(Speckled lentiginous nevus)

Question 6

[Derm/pigmented]

Diagnosis?

Large melanocytic nevi in the back, scalp, neck
Melanocytes within meninges or CNS

Answer 6

Neurocutaneous melanosis
(Congenital melanocytic nevi with CNS involvement)

Question 7

[Derm/pigmented]

Diagnosis?

Blue-gray macules and patches on the face
Does not resolve with time
10% develop glaucoma
Periodic ophthalmologic/skin exams

Answer 7

Nevus of Ota
(Nevus of Ito, on shoulder, upper extremity, neck)

Question 8

[Derm/Genetic/Ichthyoses]

Diagnosis?
Treatment?
Condition associated with X-linked?

prominent scales on the extensor surfaces of the legs and hyperlinear palms

Answer 8

Ichthyosis vulgaris

• Treatment:
  Emollient containing an α-hydroxy acid (eg, ammonium lactate)
• X-linked:
  Cryptorchidism, increased risk for testicular cancer

Question 9

[Derm/Genetic/Ichthyoses]

Diagnosis?
Its two types?

LI

Answer 9

Autosomal recessive congenital ichthyosis (ARCI)

• Types: both are spectrum
  Lamellar ichthyosis (large, dark patelike scaling)
  Congenital ichthyosiform erythroderma (smaller, fine scales)

CIE

Question 10

[Derm/Genetic/Pigmentation]

Diagnosis?
Cause?
Associated condition?

Answer 10

Oculocutaneous albinism

• Cause:
  tyrosinase deficiency
• Associated with:
  Eye problem - photophobia, nystagmus, poor visual acuity
  Increased risk of skin cancer

Question 11

[Derm/Genetic/Pigmentation]

Diagnosis?

X-linked (dominant, male lethal)
Neuroectoderm dysplasia - skin, hair, teeth, CNS, eyes
Teeth: Delayed eruption of the teeth
Eye: Strabisumus
CNS: seizures, intellectual disability
Management with emollients, topical steroids

Answer 11

Incontinentia Pigmenti

Question 12

[Derm/Genetic]

Diagnosis?

Simplex: deep layer, basal keratinocytes
Junctional: basement membrane proteins
Dystrophic: below the basement membrane, type 7 collagen

EBS

Answer 12

Epidermolysis bullosa

DEB

Question 13

[Derm/Genetic/Ectoderm]

Diagnosis?

X-linked recessive
Face: saddle nose, frontal bossing, everted lips
Hair: sparce
Teeth: missing or peg-shaped teeth
Sweat: absent sweating, high risk for hyperthermia

Answer 13

Hypohidrotic ectodermal dysplasia

Question 14

[Derm/Genetic/Ectoderm]

Diagnosis?

Hair, nail dysplasia
Progressive hyperkeratosis of the palms and soles
Normal sweating

Answer 14

Hidrotic Ectodermal Dysplasia
(Clouston syndrome)

Question 15

[Derm/Pigmentation]

Indication for excision/biopsy in acquired melanocytic nevi (4)

Answer 15

1. become painful or pruritic
2. ulcerate
3. change in size, color, shape
4. prone to trauma

Question 16

[Derm/Pigmentation]

Diagnosis?
Malignancy?

Often in male
Cutaneous hamartoma
Often with hypertrichosis

Answer 16

Becker Nevus

• No malignancy potential

Question 17

[Derm/Pigmentation]

Diagnosis?
Associated conditions (3)?

Depigmentation often with skin trauma (Koebner phenomenon)

Answer 17

Vitiligo

• Associated with:
  AR polyglandular deficiency
  Autoimmune endocrine (T1DM, Graves, Adrenal insufficiency, Hypothyrodism, Hypoparathyroidism)
  Pernicious anemia

Question 18

[Derm/Pigmentation]

Diagnosis?

Common in childhood
Hypopigmented to skin-colored papuls
In Blaschkoid distribution (embryonic ectodermal lines of migration)
No treatment needed

Answer 18

Lichen Striatus

Question 19

[Derm/Pigmentation]

Diagnosis?
Treatment?

Pain and pruritis
Often in female
Anywhere but often in vulva, perinium, glands penis

Answer 19

Lichen Sclerosus

• Treatment:
  Topical corticosteroid

Question 20

[Derm/Atopy]

Diagnosis?
Associated disease?

Hypopigmented pathes with fine scale
Usually cheeks and extensor extremities
Treatment with reassurance, emollients and topical steroids

Answer 20

Pityriasis alba

• Associated with:
  atopic dermatitis

Question 21

[Derm/Atopy]

Diagnosis?
Associated disease?

Redness, cracking of the weight-bearing part of the soles
Interdigital webs are not affected

Answer 21

Juvenile plantar dermatosis

• Associated with:
  atopic dermatitis

Question 22

[Derm/Atopy]

Diagnosis?

Small, firm multilocular vesicles on the palms, soles, fingers

Answer 22

Dyshidrotic eczema

Question 23

[Derm/Acne]

Diangosis?
Treatment?

Acne-like papules, erythema, telangiectases
Flushing reactions to stimuli
May accompany conjunctivitis, blepharitis, iritis, keratitis

Answer 23

Perioral dermatitis
(Acne Rosacea in children)

• Treatment:
  Topical sulfacetamide, metronidazole
  Oral tetracyclines

Question 24

[Derm/Hair]

Diagnosis?

~3 months after severe stress (surgery, withdrawal of hormone therapy, medications (BB, amphetamines, ACEi, OCP)
Many hair pulled out from tugging test
Hair follicle under microscopy: cornified, depigmented, club-shaped bulb without attached root sheath

Answer 24

Telogen Effluvium

Question 25

# [Derm/Pigmentation] Diagnosis? Brown to black plaques Neck, face, trunk Unknown etiology, benign phenomenon Wiped off with alcohol swab Treat with rubbing alcohol

Answer 25

Terra Firma-Forme Dermatosis

Question 26

# [Derm/Inflammatory] Diagnosis? Treatment? Small, scaly papules Asymptomatic or sometimes pruritic Preceded by strep pharyngitis or perianal strep Discoloration under the nail, pitting nail

Answer 26

Guttate psoriasis (childhood psoriasis) - Treatment: topical steroid, topical vitamin D analog (calcipotriene)

Question 27

# [Derm/Infection] Diagnosis? Cause? Brown to pink, well-defined patches Axillae, groin, toe webs Flouresces bright red with a Wood lamp Treat with topical erythromycin/clindamycin

Answer 27

Erythrasma - Cause: Corynebacterium minutissimum

Question 28

# [Derm/Infection/Fungal] Treatment option for Tinea of the skin, groin, and feet: __ Tinea of the nail and hair: __

Answer 28

Tinea of the skin, groin, and feet: _Topical_ terbinafine or -azole Tinea of the nail and hair: _Systemic_ griseofulvin or terbinafine

Question 29

# [Derm/Infection/Fungal] Diagnosis? Autoeczematization of the tinea or seborrheic dermatitis Pruritic, maculopapular eruption Distant sites of the infected area Treatment: continue antifungal, add topical steroid

Answer 29

Dermatophytid (Id) reaction

Question 30

# [Derm/Infection/Fungal] Diagnosis? Scaly macules, patches Hypopigmented, pink/brown KOH with spaghetti and meatballs Treat with topical azole

Answer 30

Tinea vesicolor (Pityriasis vesicolor)

Question 31

# [Derm/Infection] Diagnosis? Treatment? Children with diffuse eruption with papules, vesicles the face, palms, soles Adolescent, pruritic papules in the interdigital web, volar wrists Household member with itchiness

Answer 31

Scabies (Sarcoptes scabiei) - Treatment: 5% permethrin overnight repeat in a week

Question 32

# [Derm/Blistering] Diagnosis? Mechanism? Hyperpigmentation and tense vesicles In sun-exposed areas Heal with milia formation Increased iron, hematocrit, urinary copoporphyrins and uroporphyrins

Answer 32

Porphyria Cutanea Tarda - Mechanism: Build up of phototoxic porphyrins in the skin

Question 33

# [Derm/Round] Diagnosis? Asymptomatic Pink, annular plagues without scales Distal extremities Self-limiting

Answer 33

Granuloma Annulare

Question 34

# [Derm/infection] Diagnosis? Christmas-tree appearance HHV 6 or 7 infection

Answer 34

Pityriasis Rosea

Question 35

# [Derm/Inflammatory] Diagnosis? Associated condition? Painful ulceration Usually in anterior tibial surface Rapidly become necrotic, cribriform scarring

Answer 35

Pyoderma Gangreosum Inflammatory Bowel Disease (Crohn's disease)

Question 36

# [Derm/Drug] Diagnosis? Frequently associated conditions? Mild pruritis Target lesions symmetric distribution, palms and soles Self-limited hypersensitivity

Answer 36

Erythema multiforme HSV infection

Question 37

# [Derm/Inflammatory] Diagnosis? After viral illness Erythematous papules, macules in the extremities, sparing trunk Might persist for a few weeks to months

Answer 37

Papular acrodermatitis of childhood (Gianotti-Crosti syndrome)

Question 38

# [Derm/Inflammatory] Diagnosis? Treatment? Rash resembles varicella but persists Mildly pruritic, burning, papules and vesicles with hemorrhagic crusts Hypopigmentation, hyperpigmentation after rash Relapsing and remitting course

Answer 38

Pityriasis Linchenoides et Valioriformis Acuta (PLEVA) - Treatment: Long term erythromycin or tetracyclines 6-8 weeks

Question 39

# [Derm/Inf] Diagnosis? Treatment? Painful, inflammed area Hairloss, +/- fever

Answer 39

Kerion (Severe Tinea Capitis) - Treatment: Oral griseofulvin or terbinafine