MKSAP DERM I

Question 1

To diagnose autoimmune bullous disease, you need:

Answer 1

two biopsies; one of lesional skin for histology and one of perilesional normal skin for direct immunofluorescence

Question 2

Young adult as asymptomatic, oval-to-round, minimally scaly, hyperpigmented or hypopigmented macules that coalesce into patches on trunk and upper extremities

Answer 2

Pityriasis versicolor

Potassium hydroxide microscopic exam with: visualization of short rod-shaped hyphae and round yeast (“spaghetti and meatballs”)

Treatment: topical antiseborrheic shampoos or lotions such as selenium sulfide or ketoconazole leads to resolution of erythema and scaling, but the pigmentation changes may persist for longer periods of time.

Question 3

What is Erythrasma?

Answer 3

Superficial bacterial infection caused by Corynebacterium minutissimum

Presents as mildly pruritic, thin erythematous-to-brown plaques with thin scale and an overlying wrinkled appearance and maceration in intertriginous areas such as the axillae, groin, and inframammary areas.

Question 4

What is topical mupirocin used for?

Answer 4

Localized bacterial infections of the skin (like impetigo)

Question 5

What is epicutaneous patch testing used for?

Answer 5

Diagnose allergic contact dermatitis

Question 6

When individual urticarial lesions last longer than 24hrs, leave behind bruises and is associated with systemic symptoms (joint pain), and more often painful rather than itchy, what are you concerned about?

Answer 6

Urticarial vasculitis (often associated with underlying SLE).

Diagnosed with skin biopsy and treated with PO steroids.

Question 7

Erythematous, violaceous, or hypopigmented linear striations in the setting of topical glucocorticoid use.

Answer 7

Striae distensae (stretch marks from topical steroids)

Question 8

Chronic paronychia

Answer 8

Loss of cuticle with tender edematous nail folds, involving multiple fingers, associated with wet work, insidious >6 weeks

Primary management minimizing wet work and topical steroids (partial an eczematous process though Candida is often isolated)

Question 9

Definition of mod to severe psoriasis

Answer 9

> 30% of body involvement

Treat with MTX (avoid prednisone PO)

Question 10

Solo topical medicines for psoriasis are good for mild cases with less than ____ body surface area involvement.

Answer 10

10%

Question 11

First line therapy for PUPPP (pruritic urticarial papules and plaques of pregnancy)

Answer 11

low to medium strength topical steroids

Question 12

Patient immobilized from surgery/critical care/pain with superficial clear vesicles or as multiple discrete red papules

Answer 12

Miliaria (heat rash)

Question 13

What is Acute generalized exanthematous pustulosis?

Answer 13

Febrile drug reaction occurring 1-2 days after trigger (B-lactam abx frequently)

Presents as punctate nonfollicular sterile pustules on a background of erythema. Starting on the face and intertriginous areas and spreads to the trunk and extremities.

Question 14

Skin findings characteristic of dermatomyositis, but without clinical or laboratory evidence of muscle disease

Answer 14

Amyopathic dermatomyositis (carries risks for underlying malignancy and pulm fibrosis)

Question 15

Most common strains of HPV causing anogenital wards?

Answer 15

HPV 6 and 11

Question 16

What is dermatitis herpetiformis?

Answer 16

A subepidermal autoimmune blistering disease that is extremely pruritic.

Small tense vesicles and papules which are rarely intact due to the extreme pruritis on elbows, knees, and buttocks

Question 17

First line therapy for impetigo

Answer 17

Topical mupirocin