Dermatology

Question 1

What does acetowhite testing evaluate for?

Answer 1

Wart evaluation using acetic acid

Question 2

A 15-year-old male presents with lichenification of the dorsal aspects of his feet. He says that he has itching there and a rash several times per year as long as he can remember. Diagnosis? What is the treatment of choice?

Answer 2

Atopic dermatitis - Topical steroids, UVB phototherapy as an adjunct

Question 3

A 65 yo F describes a group of vesicles on her arm which started earlier this fall evolved in to the coin shaped plaques you observe on exam with an erythematous base and clearly demarcated borders. She reports pruritus. What is the diagnosis? Tx?

Answer 3

Nummular dermatitis - topical steroids

Question 4

A young woman has an outbreak on her lip that does not affect the vermilion boarder, they are papulopustules on erythematous bases a few of which have become confluent. What is the diagnosis? Tx?

Answer 4

Perioral dermatitis - rule out infection, usually improves with topical antibiotics. Avoid steroids - will worsen

Question 5

Pt complaining of pruritic plaques on flexural surfaces, dorsum of hands and feet with relapsing remitting course since childhood. Diagnosis? Cause? mainstay of treatment?

Answer 5

Atopic dermatitis, type 1 IGE hypersensitivity reaction, topical steroids

Question 6

Pt with a long standing area of pruritus and lichenification has a negative KOH prep and biopsy shows hyperplasia and hyperakeratosis. Diagnosis? management?

Answer 6

Lichen simplex chronicus, control itch-scratch cycle

Question 7

Pt had a solitary round pink plaque with a raised border of fine scales that disappeared then 1 week later she developed a trunkal rash of oval, salmon-colored, slightly raised, papular and macular lesions about 1cm in diameter. In looking at her back, the rash appears to have a christmas tree like distribution. Diagnosis? treatment?

Answer 7

Pityriasis rosea, watchful waiting

Question 8

9 year old patient presents with discrete, flesh-colored, waxy, dome shaped umbilicated papules on the face, trunk and extremities 3-6mm in size which appear in groups. A white material cam be expressed from the lesions. Diagnosis? Treatment?

Answer 8

Molluscum contagiosum , watchful waiting

Question 9

A patient presents with flat-topped, shiny, violaceous papules with fine white lines on the surface. The lesions are very painful and grouped together on her wrists and eyelids. How do you confirm the diagnosis? Diagnosis? Concominant condition? Treatment?

Answer 9

confirm with biopsy and immunofluorescence
Dx: Lichen Planus
Screen for Hep C
Topical steroids or cyclosporine wash in mouth

Question 10

A patient presents with large pruritic plaques on the knees with distinct margins and adherent silvery scales which, when peeled away, produces specks of bleeding from the capillaries. Diagnosis?

Answer 10

Psoriasis

Question 11

Pt presents with painful bullous lesions in the oral mucosa that she knows are common in her family. Diagnosis? treatment?

Answer 11

pemphigus vulgaris, systemic prednisone + immunosuppression

Question 12

Patient has an infected area of scalp after a hot tub experience. Likely organism? treatment?

Answer 12

Pseudomonas, bactroban

Question 13

What are the most common offenders of steven-johnson’s syndrome (3 categories, 1 specific meds)

Answer 13

abx (sulf/pcn/fq/cef/cyclines), psych/EP (phenobarb/phenytoin/carbamazepin/valproic acid), steroids, allopurinol

Question 14

Pt presents with fever, sore throat/mouth, oral eruptions, photophobia. Hx of sinus infection being treated. Diagnosis? confirmatory testing? treatment?

Answer 14

steven johnson’s syndrome, biopsy is diagnostic, removal of causative agent, transfer to burn unit

Question 15

What is the treatment for hidradenitis suppurativa?

Answer 15

I&D, local triamcinolone, oral abx until lesions resolve

Question 16

What is the treatment of an abscess with fever? without?

Answer 16

with: systemic abx + I&D, otherwise just I&D

Question 17

What is the treatment duration for dermatophytosis?

Answer 17

4 weeks of topical applications

Question 18

What is the major contraindication to systemic antifungal treatment?

Answer 18

hepatic dysfunction

Question 19

With what condition is the organism Malassezia furfur associated?

Answer 19

tinea versicolor

Question 20

Scraping and KOH prep of a hypopigmented scaling macule shows hyphae and spores. What is the diagnosis? treatment?

Answer 20

tinea versicolor, selenium sulfide shampoo left on for 15 minutes for 7 days in a row

Question 21

A patient with small pruritic papules in webs of fingers and toes. How do you diagnose? diagnosis? treatment?

Answer 21

mineral oil scraping for microscopy is confirmative for scabies, treat with lindane (>age 2) or permethrin for 8 hours twice over 7 days and wash all contacting fabrics

Question 22

How are the neurologic manifestations of a black widow spider managed?

Answer 22

diazepam and calcium gluconate

Question 23

Patient presents thinking that they may have had an insect bit but now there is a sinking macule that is pale gray in color and slightly eroded at the center with a halo of very tender inflammation. diagnosis? treatment?

Answer 23

brown recluse spider bite: local analgesia, regresses in 5-10 days spontaneously

Question 24

Patient presents with small beige to brown plaques with a velvety, warty surface that appears stuck on. diagnosis? treatment?

Answer 24

seborrheic keratosis, electrodessication of 5-fluorouracil (will look worse before better) for 2-4 weeks

Question 25

What is the most common type of melanoma?

Answer 25

spreading malignant melanoma

Question 26

What type of melanoma is associated with the palms, soles and nail beds?

Answer 26

acral lentiginous melanomas

Question 27

What stage decubitus ulcer may be described as superficial necrosis or partial thickness involving the epidermis and/or dermis; shallow ulcer

Answer 27

stage II

Question 28

What stage decubitus ulcer may be described as being deep necrosis, a crater ulcer with full-thickness skin loss, damage or necrosis can extend down to, but not through fascia

Answer 28

stage III

Question 29

What is the medical name for the darkening of the lower extremities in diabetic patients?

Answer 29

acanthosis nigrans