MKSAP Derm III

Question 1

Well-circumscribed, brown to black macules that most commonly occur on lower lip (though they can also be seen on gingiva, buccal mucosa or tongue)

Answer 1

Melanotic macule

Question 2

Chronic red-to-tan scaly patches with erosions on lower lip

Answer 2

Actinic chelitis (which is a premalignant condition as a precursor to squamous cell carcinoma in situ)

Treatment with topical chemotherapy agents (5-fluorouracil), imiquimod, laser therapy, photodynamic therapy, or cryotherapy is recommended.

Question 3

What is an amalgam tattoo?

Answer 3

Localized pigmentation on buccal mucosa from amalgam dental fillings. Appear as blue-gray macules and do not change over time

Question 4

Isolated, circumscribed, indurated plaques on torso and proximal extremities (small red or purple patches that develop into firm white or ivory centers) and makes skin tight and less flexible

Answer 4

Morphea (localized scleroderma)

Question 5

Large, noninflammatory woody-indurated plaques over shoulder girdle, neck, and upper extremities (ofen a complication of diabetes or monoclonal gammopathy)

Answer 5

Sclerederma

Question 6

Deposition of mucin with large numbers of stellate fibroblast in the dermis, presenting as waxy yellow-red papules overlying thickened skin affecting the face, upper torso, and upper extremities

Answer 6

Scleromyxedema (associated with paraproteinemia so like multiple myeloma or AL amyloidosis) can be associated with mild inflammatory myopathy

Question 7

Blue-black smooth or eroded nodules/mole

Answer 7

nodular melanoma (most aggressive form of malignant melanoma)

Question 8

Well-demarcated macules and patches that occur on sun-exposed skin of older person on face and dorsal hands

Answer 8

Solar lentigines

Question 9

When does DRESS occur after initiation of offending agent?

Answer 9

2-6 weeks

Question 10

When does a morbilliform eruption begin after a drug exposure?

Answer 10

4-14 days
Can see peripheral eosinoprilia or leukocytosis but NO other signs of systemic involvement (unlike DRESS which can have facial edema, LFT abnormalities, skin pain, etc)

Question 11

Hypopigmented patches with border irregularity and fine scale on face and upper arms of dark-pigmented children

Answer 11

Pityriasis alba

Question 12

Hypopigmented, hyperpigmented, or pink patches that are dry and slightly scaly

Answer 12

Tinea versicolor (caused by Malassezia furfur)

Question 13

Painful, exudative ulcer with purulent base and ragged edematous, violaceous “overhanging” border (associated with IBD most commonly)

Answer 13

Pyoderma gangrenosum

autoimmune neutrophilic dermatosis

Question 14

Painful subcutaneous nodule or plaques with overlying red-brown discoloration and often superimposed angulated purpuric patches often with central necrosis

Answer 14

Calciphylaxis (if it’s advanced, pts may have ulceration or large, thick, black eschar formation)

Question 15

Where do venous stasis ulcers usually form?

Answer 15

Medial aspects of the lower legs