Dermatology

Question 1

What is the most likely diagnosis and best treatment for adolescent pt presenting with grayish-tan/ brown pigmentation with irregular margins associated with widespread coarse dark hair?

Answer 1

Becker nevus

tx: cosmetic intervention

Question 2

What is the most likely diagnosis and best treatment for pt presenting with pruritic, reddish brown macules and papules that evolve into vesicular and necrotic lesions in symmetrical distribution, often misdiagnosed as chicken pox or scabies?

Answer 2

PLEVA (pityriasis lichenoides et varioliformis acuta)

tx: oral erythromycin

Question 3

What is the most likely diagnosis for patient presenting with inflammatory vesicles and bullae over trunk and extremities associated with peripheral eosinophilia that progress to irregular linear verrucous lesions then progresses to brownish-gray hyperpigmented lesions and then to isolated streaked hypopigmented linear atrophic lesions, often a family history?

Answer 3

Incontinentia pigmenti

X-linked dominant

Question 4

What are associated abnormalities that can occur in pt with Incontinentia pigmenti? (4)

Answer 4

1. delayed dentition
2. pegged or conical teeth
3. partial anodontia
4. alopecia

Question 5

What is the difference between Stevens Johnson syndrome and toxic epidermal necrolysis?

Answer 5

Epidermal detachment
SSJ: less than 10% epidermal detachement
TEN: more than 30% epidermal detachment

Question 6

What is the most likely diagnosis for patient presenting with tender, firm, nonfluctuant, dusky red pretibial nodules bilaterally?

Answer 6

Erythema nodosum

Question 7

What is the most likely diagnosis for pt presenting with erythema nodosum, recurrent oral/ genital aphthous ulcers, and uveitis?

Answer 7

Behcet disease

Question 8

What is the most likely diagnosis for pt presenting with very dry skin resembling fish scale on the extensor surfaces and hyperlinear palms with accentuated skin markins?

Answer 8

Ichthyosis vulgaris

(autosomal dominant)

(tx: hydration with bathing and moisturizing)

Question 9

What is the most likely diagnosis and best treatment for pt presenting with recurrent painful boils (deep seated rounded nodubles) in the armpit and inguinal folds?

Answer 9

Hidradenitis Suppurativa

TX: topical and oral antibiotics, spironolactone, systemic steroids

Question 10

What is the most likely diagnosis for a newborn presenting with heart block and erythematous, well circumscribed, annular plaques that leave behind central ecchymotic atrophic areas on the scalp, periocular, and sunexposed areas?

Answer 10

Neonatal lupus eythematosus

Question 11

What is the most likely diagnosis for pt presenting with shiny, smooth skin and mild fine scaling overlying the distal portions of the toes and plantar surfaces and has history of eczema, rash spares intertriginous areas?

Answer 11

Juvenile plantar dermatosis

(due to hyperhidrosis and frictional irritation)

tx: keep feet dry with foot powders

Question 12

What is the most likely diagnosis and associated condition for pt presenting with smooth, firm, papules or annular plaques without scales that resolves over 1-2 uyears?

Answer 12

Granuloma annulare

associated with type 1 diabete

Question 13

What is the most likely diagnosis and associated complication for an Asian/ African pt presenting with bluish-gray irregular patchy pigmentation on the face in the ophthalmic and/or maxillary distribution of the trigeminal nerve?

Answer 13

Nevus of Ota

associated with glaucoma, optic disc hemangiomas

Question 14

What is the difference between tinea pedis and juvenile plantar dermatosis?

Answer 14

involvement of intertriginous areas
Tinea: yes
JPD: no

Question 15

What are more concerning side effects of isotretinoin for the treatment of acne? (4)

Answer 15

1. athralgia
2. photosensitivity
3. bone marrow suppresion
4. hepatotoxicity

Question 16

What is the most likely diagnosis for newborn presenting with erythematous, blotchy macules and papules that evolve into yellow pustules on an erythematous base and usually fade in 5-7 days?

Answer 16

Erythema toxicum neonatorum

Question 17

What is the most likely diagnosis of a pt presenting with URI prodrome, elevated indurated violaceous painful nodules/ papules/ plaques asymmetrically on face, neck and limbs that can progress to bullae with associated fever, arthralgias, and leukocytosis, biopsy shows dense neutrophilic perivascular infiltration of dermis?

Answer 17

Sweet syndrome

associated with acute lymphoblastic leukemia