PAMS: Dermatology -Other Dermatologic Disorders

Question 1

What is the Tx of Achrocordon ?

Answer 1

It is mainly cosmetic; cryosurgery, electrodessication, simple
excision, shave excision

Question 2

What is the prognosis of Cafe-au-Lait Macule?

Answer 2

IF > 6 CAFE-AU-LAIT LESIONS:
▪ Tuberous sclerosis
▪ Neurofibromatosis
▪ McCune-Albright syndrome
▪ Fanconi anemia

Question 3

What is the presentation of stage-01 pressure ulcer ?

Answer 3

Itis a Non-blanching erythema which should dissappear in 5-
10 minutes after repositionin. Persistent erythema indicates damage.

Question 4

How to perform a Finger-tip pressure test?

Answer 4

With one finger, press over the area of erythema and relase the pressure. The skin will blanch or non-blanch depending on the type of pathology.

Question 5

What is the presentation of Pressure Ulcers – Stage II?

Answer 5

These are shallow ulcers with red wound bed and no sloughing.

Question 6

What is the clinical presentation of pressure ulcer stage-3?

Answer 6

Full Thickness Skin Loss
* SubQ fat may be visible
* Bone, tendons and
muscle NOT visible
* Slough may be present

Question 7

What is the presentation of stage IV pressure ulcer ?

Answer 7

Full Thickness Tissue Loss
* Exposed and palpable
tendons, muscle and bone
* Slough or eschar may be
present

Question 8

What is the management of stage 01 pressure ulcer ?

Answer 8

maintain good hygiene; daily wash with soap and water

Question 9

What is the management of stage 02 pressure ulcer ?

Answer 9

daily cleaning with saline solution; cover with occlusive dressing.

Question 10

What is the management of stage III and IV pressure ulcers ?

Answer 10

specialized moist to absorbent dressings (alginate, hydrocolloid)
* If necrotic → debridement
* If infected → topical antibiotic then dressing
* If persistent infection → culture
* If infected w/ systemic sx (e.g., fever) → IV/PO antibiotics

Question 11

What is the clinical presentation of Dyshidrotic Eczema?

Answer 11

• Pruritic vesicles on the palms and lateral and dorsal aspects of the fingers
• Symmetrical Lesions may coalesce, forming bullae (risk for secondary infection)
• Recurrent, multiple episodes over years.
• Resolves with time

Question 12

What is the management of dyshydrotic eczema ?

Answer 12

Avoid trigger (if known)
* General measures
* Topical steroids or calcineurin inhibitors (e.g., tacrolimus)

Question 13

What is the clinical presentation of epidermal inclusion cyst?

Answer 13

discrete, freely-movable cyst or nodule with
central punctum.

Question 14

What is the risk associated to multiple epidermal cysts ?

Answer 14

Colon cancer.

Question 15

What is the pathophysiology of Hidradenitis Suppurativa?

Answer 15

It is caused by sebaceous gland atrophy causing Lymphocytic infiltration and hyperkeratosis of the pilosebaceous unit. Leading to cytokines mediated Hair follicle destruction and granuloma
formation. Healing is accompanied by sinus tract formation.
https://youtu.be/QRc8sEd46lg?si=PWAReqbqON7xj4j1

Question 16

What is the epidemiology of Hidradenitis Suppurativa?

Answer 16

• Prevalence anywhere from < 1% to 4%
• Female 3:1
• Onset in 20s for most patients

Question 17

What are the risk factors for Hidradenitis Suppurativa?

Answer 17

Family Hx – autosomal dominant pattern of inheritance in some cases
* Overweight
* Smoking
* Female sex.

Question 18

What is the clinical presentation of Hidradenitis Suppurativa?

Answer 18

Pain, burning, itching and hyperhidrosis 24 to 48 Hrs prior to Lesions onset at the Intertriginous areas. The lesions are nodules and subcutaneous abscess with sinus tract formation and purulant discharge. Lasts days to months and heals with fibrotic scarring.

Question 19

What is the presentation of Hurley stage 01 Hidradenitis Suppurativa?

Answer 19

localized and includes the formation of single or multiple
abscesses, without sinus tracts and scarring

Question 20

What is the presentation of Hurley stage 02 Hidradenitis Suppurativa?

Answer 20

recurrent abscesses, with sinus tract formation and
scarring, occurring as either single lesions or multiple, widely
separated lesions

Question 21

What is the presentation of Hurley stage 03 Hidradenitis Suppurativa?

Answer 21

diffuse or nearly diffuse involvement of the affected
region, with multiple interconnected tracts and abscesses across
the entire area

Question 22

What is the medical management of Hidradenitis Suppurativa?

Answer 22

Topical antibiotics
* Oral antibiotics
* Monoclonal antibodies (MAB)

Question 23

What is the pathophysiology of weals and pruritis in utricaria ?

Answer 23

Release of chemical mediators by mast cells and basophils

Question 24

What is the pathophysiology of angioedema

Answer 24

Release of bradykinin.

Question 25

What is the Tx of utricaria ?

Answer 25

• Oral second-generation H1-antihistamine
  *Oral corticosteroids – if unresponsive to antihistamine or severe,
  widespread urticarial.
• IM adrenaline (epinephrine) – only in situations of airway
  compromise from sever angioedema

Question 26

Melasma and post inflammatory hyperpigmentations are seen in what type of skin ?

Answer 26

Type IV-VI

Question 27

Solar Lentigo is seen in what skin type ?

Answer 27

1 to 3

Question 28

what is the clinical significance of solar lentigo?

Answer 28

Must differentiate from actinic keratosis and lentigo maligna
* Premalignant condition
* Warning signs: rapid growth change, pain, itching, easy or recurrent
bleeding, poor healing
* Can be difficult to distinguish from early seborrheic keratosis

Question 29

What is the Tx for solar Lentigo ?

Answer 29

Ablative therapies - chemical peels, cryotherapy, laser therapy
* Topical therapies - hydroquinone, retinoids

Question 30

What are the two forms of albinism ?

Answer 30

Two forms
○ Oculocutaneous - skin, hair, and eyes without
melanin production
○ Ocular - only eyes affected

Question 31

Why should we biopsy cherry angioma sometimes ?

Answer 31

To rule out melanoma as it may look alike