Pigmentary Disorders

Question 1

pathology of vitiligo

Answer 1

loss of functional melanocytes

Question 2

pathology of postinflammatory hypopigmentation

Answer 2

dysfunction in melanocyte-keratinocyte interactions

decreased melanocyte function

decreased melanin synthesis

Question 3

pathology of melasma

Answer 3

excess deposition of melanin into the epidermis or dermis

Question 4

pathology of solar lentigines

Answer 4

proliferation of basal melanocytes and subsequent increase in melanization

Question 5

pathology of ephelides

Answer 5

increased melanin production

Question 6

pathology of PIH

Answer 6

increased release / production of melanin

Question 7

proposed etiologies of vitiligo

Answer 7

1. genetic
2. environmental
3. auto-immune
4. oxidative stress
5. melanocyte detachment

Question 8

Clinical presentation of progressive macular hypomelanosis

Answer 8

non scaly

trunk>

Question 9

Pathophysiology of progressive macular hypomelanosis

Answer 9

C acnes

Question 10

Wood’s lamp of progressive macular hypomelanosis

Answer 10

orange to red follicular fluorescence

Question 11

clinical presentation of postinflammatory hypopigmentation

Answer 11

ill defined

Question 12

clinical presentation of chemical/medication induced leukoderma

Answer 12

confetti-like

Question 13

medications that cause leukoderma

Answer 13

1. plaquenil
2. methylphenidate (ADHD)
3. topical steroids
4. IL TAC
5. immune checkpoint inhibitors
6. EGFR inhibitors
7. Azelaic acid
8. Imiquimod
9. Optic preparations

Question 14

treatment for confluent/reticulated papillomatosis

Answer 14

minocycline 50-100mg BID 1-3 months

azithromycin 250-500mg three times weekly x 3-4 weeks

Question 15

there is a rare malignant form of acanthosis nigricans associated with ______ malignancy

Answer 15

GI

-onset in middle age/adult
-unusual locations on the body

Question 16

drugs that cause acanthosis nigricans

Answer 16

Oral contraceptives

Testosterone

Insulin

Niacin

Question 17

risk factors for melasma

Answer 17

1. Hormone replacement therapy
2. Pregnancy
3. Oral contraceptives
4. UVR
5. Photosensitizing meds

Question 18

Pattern of clinical presentation of melasma

Answer 18

1. centrofacial
2. malar
3. mandibular

Question 19

major difference clinically between solar lentigines and ephelides

Answer 19

lentigines:
-DO NOT FADE IN WINTER

ephelides:
-FADE IN WINTER

Question 20

etiology of exogenous ochronosis

Answer 20

most commonly associated with prolonged use of hydroquinone or other lightening agents in combo with UV exposure

may not resolve

Question 21

drug known to cause drug-induced hyperpigmentation

Answer 21

minocycline

Question 22

what is erythema ab igne

Answer 22

hyperpigmentation due to prolonged exposure to heat (laptops, heating pads, electric heaters)

reticular pattern

spontaneously resolves after weeks-months removal of heat source