Dermatology

Question 1

What is dx?
28 yr old w painless blistering on backs of hands after time outdoors. PMH of chronic Hep C. began OCP’s last month. PE shows mincrease fragility of surrounding skin, mild hyperpigmentation of face

How is dx confirmed?
What substances can trigger this?

Answer 1

Porphyria cutanea tarda - uroporphyrinogen decarboxylase deficiency

dx through elevation of urinary uroporphyrins

Ethanol, Estrogens can trigger

Question 2

How are Ehlers-Danlos and Marfan’s distinguished clinically?

Answer 2

Ehlers-Danlos:
joint hypermobility, more prominent skin findings (velvety/atrophy/scarring)
COL5A1, COL5A2 mutation

Marfan:
FBN1 mutation

Question 3

what is dx, how is dx made, what is tx?

48 yr old woman w recurrent rash. raised red patches. worse overnight w pruritis, spontaneously resolved over then next day. Repeat episodes nearly every 2-3 weeks

Answer 3

Chronic urticaria (>6weeks)
--40% pts have associated angioedema

-etiology: physical stim, NSAIDs, Idiopathic(80-90%)

Dx - made clinically, no need for labs unless systemic findings are present

Tx - daily cetirizine
(acute - <6weeks = H1 blockers, oral steroids if severe)

Question 4

What is the treatment for Actinic Keratosis?

Answer 4

20% risk of progression to squamous cell carcinoma

• cryosurgery or surg excision
• if widespread: field therapy (5-fu cream for 3-6 weeks, imiquimod, diclofenac)

Question 5

What is the most common microbiologic etiology of erysipelas?

Answer 5

S. pyogenes, GAS

Question 6

How do you treat rosacea? what is a common comorbidity?

Answer 6

Metronidazole

–ocular symptoms (burning, foreign body sensations, recurrent chalazion)