MKSAP Derm V

Question 1

atrophic, orange-colored patches often associated with visible vasculature from skin thinning; the lesions may ulcerate. Sometimes assoc with DM with end-organ damage (retinopathy, nephropathy)

Answer 1

Necrobiosis lipoidica

Question 2

skin fragility and small, transient, easily ruptured vesicles in sun-exposed areas, mainly on the hands; these eventually rupture, forming erosions, dyspigmentation, and scarring

Answer 2

Porphyria cutanea tarda

Question 3

Initial treatment for pyoderma gangrenosum

Answer 3

Prednisone (avoid surgery because this rash occurs at site of traumas)

Question 4

Severe allergic contact dermatitis treatment

Answer 4

2-3 week taper of systemic glucocorticoids

Question 5

Treatment of tinea of non–hair-bearing skin includes topical antifungal agents such as ______; ____ is not effective, and oral _____ should be avoided.

Answer 5

1. imidazole, miconazole, clotrimazole, ketoconazole, ciclopirox, or terbinafine
2. topical nystatin
3. ketoconazole

Question 6

Retiform purpura is associated with:

Answer 6

Angulated or netlike configuration that reflects the underlying vascular structure in the skin. Various conditions can cause retiform purpura, many of which disrupt arterial blood flow such as thrombosis and embolization.

Question 7

Pruritus in the absence of skin findings should be evaluated for underlying systemic causes; many medications such as _____, _____, ____, or _____ can also cause generalized pruritus without skin findings.

Answer 7

hydrochlorothiazide, calcium channel blockers, opiates, or NSAIDs

Question 8

Noninfiltrating basal cell carcinomas on low-risk areas such as the trunk and extremities are best treated with ____.

Answer 8

electrodesiccation and curettage

Question 9

What is Vismodegib used for?

Answer 9

Oral medication that inhibits the hedgehog signaling pathway; this signaling pathway is aberrant in most basal cell carcinomas. It is reserved for locally advanced or metastatic basal cell carcinomas.

Question 10

Superficial infection of the scalp, seen mostly in school-aged children. It can appear as a patchy, nonscarring alopecia with broken hair shafts. Occipital lymph nodes can often be palpated.

Answer 10

Tinea capitis

Question 11

Generalized waxy appearance, ecchymoses with minor pressure (“pinch purpura”), ecchymoses around the eyes (“raccoon eyes”), yellow waxy papules and plaques especially in a periorbital location, dystrophic nails, and macroglossia.

Answer 11

Skin manifestations of amyloid light chain amyloidosis are present in 30% to 40% of patients and include

Question 12

Heliotrope rash, a distinctive purple or lilac erythema of the eyelids that may be accompanied by edema

Answer 12

Dermatomyositis

Question 13

Eruptive xanthomas, characterized by yellow papules with surrounding erythema, are pathognomonic of ____. Several grouped 1- to 5-mm yellow papules on extensor surfaces of extremities and buttocks.

Answer 13

Hypertriglyceridemia

Question 14

Yellow to red papules or nodules up to 3 cm in size located over joints and extensor surfaces of the elbows and knees.

Answer 14

Tuberous xanthomas associated with markedly elevated low-density lipoprotein levels (familial hypercholesterolemia) and elevated intermediate-density lipoprotein and triglyceride levels (familial dysbetalipoproteinemia).

Question 15

What is acrochordon also called?

Answer 15

skin tag

Question 16

benign, fibrohistiocytic lesions common on the extremities of young adults, in particular women. Firm brown or reddish papules about the size of a pencil eraser that most commonly occur on the lower extremities; they “dimple” when lateral pressure is applied to the lesion with the thumb and first finger.

Answer 16

Dematofibroma

Question 17

Bright red vascular lesions that arise suddenly and grow rapidly; they often appear during pregnancy or in the setting of certain medications (such as antiretroviral therapy). The name is misleading, as they are neither pyogenic nor granulomatous. They resemble cherry hemangiomas, but are often more friable and tend to bleed more easily. They are benign lesions that do not have any systemic disease associations; they are treated with biopsy or electrocautery.

Answer 17

Pyogenic granulomas