Photodamage/Cosmetic Surgery

Question 1

Which lipid abnormality causes eruptive xanthomas?

Answer 1

Elevated Triglycerides

Question 2

What condition can be associated with patients who have xanthelasma and normal lipid levels?

Answer 2

Sebaceous hyperplasia

Question 3

This condition is caused by metabolic breakdown of lipids with deposition in the skin

Answer 3

Xanthelasma

Question 4

How can you cosmetically destroy xanthomas?

Answer 4

Trichloacetic acid 70%, cryotherapy and CO2 or Q switched Nd:YAG laser

Question 5

An appropriate treatment for telangiectasia is?

Answer 5

Intense Pulsed Dye Laser

Question 6

Telangiectasias would most likely be observed in:

Answer 6

Patients with history of significant sun exposure

Question 7

Which twrm describes a telangiectasia area that appears S a central lesion with “legs” radiating from the center?

Answer 7

Stellate

Question 8

Key difference between a lentigo and ephelid is

Answer 8

Ephelides will fade in the absence of UV light

Question 9

Solar lentigos are most commonly seen in

Answer 9

Caucasians

Question 10

Puetz-Jefferson Sybdrome is associated with

Answer 10

Intestinal polyps

Question 11

Reticulated reddish brown dyspigmented areas located on the anterior and lateral aspects of the neck sparing the area under the chin describes

Answer 11

Poikiloderma of Civatte

Question 12

A 57 year old Caucasian male with long history of outdoor employment presents with complaints of acne. Physical exam notes general facial elastosis, open/closed comedones with keratitis material located in the temples and periocular areas. The appropriate diagnosis is

Answer 12

Favre-Racouchot

Question 13

Elastosis would be noted in an elderly make with years of accumulated sun exposure in which locations

Answer 13

Back of neck, photo distributed pattern

Question 14

First line treatment for elastosis is

Answer 14

Broad spectrum sunscreen

Question 15

Second line treatment for elastosis is

Answer 15

Topical retinoid

Question 16

Tuberose xanthomas would be located on

Answer 16

Elbows

Question 17

This laser targets water of soft tissue to vaporize tissue and mostly involves the epidermis

Answer 17

Ablative

Question 18

This type of laser has a high risk for infection, scarring, pigment changes and more downtime

Answer 18

Ablative

Question 19

This type of laser mostly involves the dermis and collagen, targets water of soft tissue without vaporizing tissue

Answer 19

Non-ablative

Question 20

This type of laser involves both the dermis and epidermis. Treats small islands of epidermis compared to a continuous wave of destruction.

Answer 20

Fractionated CO2

Question 21

What patients should be excluded from laser treatment?

Answer 21

History of keloids/scarring, oral isotretinoin within past year, ectropion, Connective Tissue Disease and morphea

Question 22

What colors are the easiest to remove with tattoo removal?

Answer 22

Dark blue and black

Question 23

What is the mechanism of action for botulinum toxin type A?

Answer 23

Inhibits the release of acetylcholine in peripheral nerves into neuromuscular junction. Results in inability for muscle to contract.

Question 24

What botulinum toxin type A injection is approved for BOTH glabella line and lateral canthal lines?

Answer 24

Onabotulinumtoxin A (Botox)

Question 25

Leakage into what muscle can cause ptosis?

Answer 25

Frontalis

Question 26

Botox is contraindicated in what patients

Answer 26

Prior history if muscle weakness. Motor neuron disease, myasthenia Gravis, infection near the area to be injected

Question 27

Abotulinumtoxin A is contraindicated in patients with

Answer 27

Allergy to cow's milk due to use of bovine protein

Question 28

Treatment for eyelid ptosis includes

Answer 28

Alpha-andrenergic eye drops (0.5% apraclonidine)

Question 29

Dermal fillers are only approved for

Answer 29

Lip and cheek augmentation for individuals over the age of 21.

Question 30

What is not FDA approved for fillers?

Answer 30

Silicone, under eye areas, large scale body contouring

Question 31

Examples of biodegradable filler

Answer 31

Hyaluronic acid, calcium hydroxyapatite, poly-l-lactic acid

Question 32

Non biodegradable filler

Answer 32

Polyethylene methacrylate microspheres (PMMA)

Question 33

Absolute contraindications for filler

Answer 33

Active skin infection, hypersensitivity to filler, connective tissue disease, graft vs hose, hoshimoto's disease, hemophilia, thalassemia, anticoagulant therapy, pregnancy, breast feeding

Question 34

What causes early onset of granulomas from filler

Answer 34

Usually injection technique

Question 35

Delayed nodules following filler are usually caused by

Answer 35

Inflammatory reactions and may require hyaluronidase, lidocaine or massage

Question 36

Sudden onset of skin color changes i.e. white blotching with severe pain indicates what when doing filler injections?

Answer 36

Arterial occlusion

Question 37

Delayed onset with color changes of red/blue coloring after filler injection indicates what?

Answer 37

Venous occlusion

Question 38

Treatment of vascular compromise with filler includes:

Answer 38

Warm compress to promote vasodilation, flooding area with hyaluronidase, doppler/ultrasound to assess damage, daily injections of hyaluronidase

Question 39

What chemical peels done at 2-4 week intervals treat melasma?

Answer 39

Trichloroacetic acid, glycolic acid and alpha-hydroxyl acids

Question 40

What lasers treat melasma?

Answer 40

Non-ablative fractional laser, PDL, IPL, Nd:YAG