Compiled Review Slides

Question 1

Primary lesion?

Answer 1

Plaque

(erythematous, scaling plaque - psoraisis)

Question 2

primary lesion

Answer 2

Patch

Question 3

Primary lesion?

Answer 3

Nodule

could also say Tumor

(Pilar cyst)

Question 4

Describe

Answer 4

•D. RED-BROWN ANNULAR PLAQUE WITH A RAISED BORDER AND CENTRAL CLEARING

Question 5

primary lesion?

Answer 5

Papule on the nose. Erythematous with a central erosion. Likely a basal cell skin cancer.

Question 6

primary lesion?

Answer 6

burrow

Question 7

primary lesion?

Answer 7

macule

This is a oval brown macule. It is a melanocytic nevus. A macule is < 5mm

Question 8

primary lesion?

Answer 8

vesicle

There are many vesicles on the palm. There is also some erythema, scale and crust. This is a problem called pompholyx, otherwise known as dyshidrotic eczema.

Question 9

THE PRIMARY CELL TYPE HAS A MULTILOBED NUCLEUS. THE CELL IS?

Answer 9

neutrophil

This is a type of non-infectious neutrophilic dermatosis, sometimes seen in association with inflammatory bowel disease and other conditions. It is called pyoderma gangrenosum, and it is characterized by numerous neutrophils and skin necrosis.

Question 10

THE PRIMARY CELL TYPE SEEN IN THIS SKIN DISEASE HAS GRANULES CONTAINING SERINE PROTEASES. IT IS A?

Answer 10

Mast cell

This is a mast cell EM. The prior photo of urticaria pigmentosa shows generalized, numerous erythematous macules. These macules will form a wheal (urticate) when stroked. That is typical of mastocytosis, also called urticaria pigmentosa. Each macule contains numerous mast cells, and a biopsy makes the diagnosis

Question 11

THE PRIMARY ANTIGEN PRESENTING CELL IN THE SKIN IS?

what does it stain for?

what kind of granules?

Answer 11

Langerhans cell

Remember these cells stain with CD1a and S100 and have Birbeck granules. EM photo of Birbeck granules (tennis racket appearance)

Question 12

most likely diagnosis?

Answer 12

Impetigo

These are heavy crusts. The erosions are NOT sharply punched out and rounded, like you would expect if it were herpes.

Question 13

most likely dx?

How does patient feel? how does red area feel?

Answer 13

erysipelas

The swelling and sharp demarcation are characteristic of erysipelas. The area involved is usually very tender. The patient usually feels quite ill.

allergic contact dermatitis and rosacea are in the differential diagnosis.

Question 14

most likely dx?

Answer 14

hot tub folliculitis

Acne is NOT usually this uniform looking. Hot tub folliculitis often has pustules that look very monomorphic (the same) and uniform, with a spread of erythema away from the pustule of a few mm. This is also what staphylococcal folliculitis looks like.

Question 15

THIS CONDITION IS ASSOCIATED WITH A RO ANTIBODY. WHAT IS THE MOST LIKELY DIAGNOSIS?

Answer 15

subacute lupus erythematosis

Ro/LA antibodies are associated with subacute cutaneous lupus erythematosis. The rash is typically seen in a sun-exposed distribution. It is red and scaling, and some call it psoriasis like or “psoriasiform”.

Question 16

dx?

Answer 16

dermatomyositis

The tip off here is the upper eyelid location and the so-called “livid” or purple/violet hue. The livid erythema of the eyelids in dermatomyositis is referred to as a heliotrope.

Question 17

dx?

Answer 17

scleroderma

note how tight and smooth the skin looks, and the contractures of the fingers

ulcerations are a common complication

Question 18

dx?

Answer 18

lupus erythematosus

Discoid lupus results in this type of erythema, scaling, and in some cases, scarring. Usually the lesions are erythematous, flat topped papules and plaques in a sun exposed distribution.

Question 19

dx?

Answer 19

lupus erythematosus

The tip off here is a young woman, the butterfly distribution of facial rash, and the violaceous hue (sort of violet-purple), a color characteristic of connective tissue diseases.

Question 20

THIS MAN HAS ATOPIC DERMATITIS. WHAT OTHER DISEASE IS RELATED TO THIS SKIN DISEASE?

Answer 20

asthma

Question 21

WHAT INFECTIOUS PROCESS CHARACTERIZED BY HONEY COLORED CRUSTS IS PRESENT IN THIS PATIENT WITH SEVERE ATOPIC DERMATITIS?

Answer 21

impetigo

Remember, impetigo is caused by strep or staph and often complicates atopic dermatitis. The base of the nose is a common place for it. Staph may be carried inside the nose.

Question 22

WHICH IMMUNOGLOBULIN MIGHT BE ELEVATED IN THIS ATOPIC PATIENT?

Answer 22

IgE

Question 23

TH2 PHENOTYPE IS SEEN IN WHICH DISEASE?

•A. ECZEMA•B. ALLERGIES•C. ASTHMA•D. ALL OF THE ABOVE

Answer 23

all

Question 24

THIS SLIDE SHOWS WHAT COMMON PROBLEM IN ATOPICS?

•A. SENSITIVE SKIN•B. DRY SKIN•C. PRURITUS•D. INFECTED SKIN

Answer 24

dry skin

Question 25

ONE OF THE BEST TREATMENTS FOR DRY SKIN IS: •A. A LOTION•B. A GEL•C. A CREAM•D. A VITAMIN

Answer 25

A cream thicker the better for dry skin. Clear bland ointment like plain vaseline petroleum jelly is the ideal moisturizer for an atopic patient.

Question 26

ONE OF THE BEST TREATMENTS FOR ATOPIC DERMATITIS IS? •A. AVOID STEROIDS•B. A TOPICAL STEROID•C. A CREAM•D. A VITAMIN

Answer 26

topical steroid

Question 27

•A. ATOPIC DERMATITIS•B. IMPETIGO•C. PRURITUS•D. ALL OF THE ABOVE

Answer 27

all

Question 28

dx?

Answer 28

psoraisis Note the primary lesions: papules and plaques. Description: Multiple erythematous , scaling papules and plaques diffusely on the back.

Question 29

THIS PATIENT ALSO HAS MARKED NAIL PITTING AND PLAQUES ON THE ELBOWS ANSD KNEES. WHAT IS THE DIAGNOSIS?

Answer 29

psoraisis ## Footnote Description: Confluent erythema with scale and fissures on the palms.

Question 30

THIS PATIENT HAS A PAINFUL JOINT AND NAIL CHANGES.WHAT IS THE DIAGNOSIS?

Answer 30

psoriatic arthritis

Question 31

ALL FACTORS BELOW WORSEN PSORIASIS EXCEPT? •A. PREDNISONE WITHDRAWAL•B. LITHIUM•C. HEPATITIS•D. STREPTOCOCCUS•E. TRAUMA

Answer 31

hepatitis

Question 32

THE LARGE PLAQUE CAME FIRST, THEN THE DIFFUSE FLAT TOPPED SCALING PAPULES. WHAT IS THE DIAGNOSIS?

Answer 32

The first lesion was the herald patch of **pityriasis rosea**. This usually has a “Christmas Tree” distribution on the trunk of erythematous, scaling papules. The differential diagnosis is usually psoriasis and secondary syphilis.

Question 33

NOTE THE VIOLACEOUS PAPULES WITH RETICULATE WHITE LACY PATTERN. WHAT IS THE DIAGNOSIS?

Answer 33

lichen planus ## Footnote The lacy pattern seen in these violaceous papules is often referred to as Wickham’s striae.

Question 34

dx?

Answer 34

pityriasis rubra pilaris ## Footnote Pityriasis rubra pilaris is a “papulosquamous” dermatosis. It shows scaling erythema with typical islands of sparing where there is completely normal skin. It usually starts on the head and spreads inferiorly, resulting in erythroderma, or total body redness. The hands and feet show marked scaling, “keratoderma”

Question 35

dx?

Answer 35

Herpes simplex ## Footnote These vesicles are grouped and some are in varying stages, some grouped, some pustules.

Question 36

dx?

Answer 36

molluscum ## Footnote Molluscum are well defined papules that are smooth, with a rolled border and central crater containing infectious molluscum bodies.

Question 37

cause?

Answer 37

HPV

Question 38

dx?

Answer 38

Herpes simplex Sharply demarcated, “punched out” erosions are typical of herpes simplex. Note how the center in some cases looks depressed, or “umbilicated”.

Question 39

recurrence of what?

Answer 39

This is **varicella** zoster virus, or shingles.

Question 40

A child developed low-grade fever, sore mouth and vesicles on the palm, soles and in the mouth. The vesicles had a red halo. What is the most likely diagnosis?

Answer 40

Hand Foot and Mouth disease ## Footnote Erythema multiforme and secondary syphilis could have a similar appearance. It would, however, be unlikely that lesions would be confined to the palms, soles and mouth but this is possible. Hand-foot-and-Mouth disease is a coxsackievirus infection that is more severe in children. The incubation period averages 3-6 days. The disease is highly contagious so that similar cases in close contacts helps support the diagnosis The red halo is highly characteristic of Hand-Foot-and-Mouth disease.

Question 41

Answer 41

Warts have a uniform papillomatous surface. Psoriasis has silvery scale, seborrheic keratosis have a haphazardly cracked pattern. The keratoacanthoma has a smooth surface with a central crust.

Question 42

This child with atopic dermatitis developed the rapid onset of vesicles in areas where eczema was present. What is the diagnosis?

Answer 42

Eczema herpeticum

Question 43

dx?

Answer 43

Contact Dermatitis ## Footnote There are no papules to indicate rosacea. Also in this photo, appreciate the **eyelid involvement.** A drug rash could not be diagnosed by the face only—drug rashes are usually generalized in distribution. There are no typical findings to suggest psoriasis over other diagnoses, it would be a poor choice.

Question 44

allergen?

Answer 44

nickel

Question 45

this contact dermatitis could be casued by? •A. A FRAGRANCE•B. A SHAMPOO•C. A CREAM•D. A LOTION•E. ALL OF THE ABOVE•

Answer 45

* A. A FRAGRANCE•B. A SHAMPOO•C. A CREAM•D. A LOTION•**E. ALL OF THE ABOVE•** * TRUE ALLERGEN: FRAGRANCE/PERFUME

Question 46

what type of eczematous dermatitis?

Answer 46

Chronic. shows erythema, scaling, lichenification. No crusts, vesicles or bullae

Question 47

what type of eczematous dermatitis?

Answer 47

acute characterized by bullae or vesicles, swelling and erythema

Question 48

plant? cause of contact dermatitis

Answer 48

Poison ivy note poison oak is common on the west coast

Question 49

THE AFFERENT(INITIATION) PHASE STARTS AFTER? •A. FIRST CONTACT WITH ANTIGEN•B. SECOND CONTACT WITH ANTIGEN•C. NO CONTACT WITH ANTIGEN•D. ANY TIME

Answer 49

**•A. FIRST CONTACT WITH ANTIGEN•**B. SECOND CONTACT WITH ANTIGEN•C. NO CONTACT WITH ANTIGEN•D. ANY TIME Remember, allergens are generally of low molecular weight, have good lipid soluability, and are chemically reactive.

Question 50

T cell activation involves? •A. THE KERATINOCYTE•B. THE T CELL•C. THE LANGERHAN CELL•D. ALL OF THE ABOVE

Answer 50

•A. THE KERATINOCYTE•B. THE T CELL•C. THE LANGERHAN CELL•D. **ALL OF THE ABOVE **

Question 51

Best way to identify the T memory cell is what? •A. CHECK FOR CLA POSITIVITY•B. CHECK ITS AGE•C. CHECK ITS LOCATION•D. ALL OF THE ABOVE

Answer 51

**•A. CHECK FOR CLA POSITIVITY**•B. CHECK ITS AGE•C. CHECK ITS LOCATION•D. ALL OF THE ABOVE

Question 52

THE BEST WAY TO PROVE IF THIS IS A CONTACT DERMATITIS IS TO? •A. TAKE A GOOD HISTORY•B. SEE HOW IT DOES WITH TREATMENT•C. GUESS•D. PERFORM PATCH TESTING

Answer 52

•A. TAKE A GOOD HISTORY•B. SEE HOW IT DOES WITH TREATMENT•C. GUESS•**D. PERFORM PATCH TESTING**

Question 53

what type of eczema?

Answer 53

subacute

Question 54

what is this?

Answer 54

patch testing ## Footnote Patch testing : examples of allergic reactions seen when patch tests are removed. Graded 1+ for mild, 2+ for moderate, 3+ for strong

Question 55

dx?

Answer 55

tinea versicolor ## Footnote This is caused by the yeast, Malassezia furfur

Question 56

dx? confirmatory test?

Answer 56

Tinea versicolor patches. They can be pink, hypopigmented or tan. The tan patches in this patient are what is abnormal, and a KOH can be performed yielding the classic spaghetti and meatballs appearance.

Question 57

dx? confirmatory test?

Answer 57

tinea KOH will be + for hyphae

Question 58

positive for what?

Answer 58

KOH Prep + hyphae (tinea)

Question 59

what test? positive for what?

Answer 59

KOH + for pseudohyphae (candida)

Question 60

WHAT OTHER SKIN DISEASES CAN BE CONFUSED WITH TINEA? •A. LUPUS•B. ECZEMA•C. CUTANEOUS T CELL LYMPHOMA •D. PSORIASIS•E. ALL OF THE ABOVE

Answer 60

•A. LUPUS•B. ECZEMA•C. CUTANEOUS T CELL LYMPHOMA •D. PSORIASIS•**E. ALL OF THE ABOVE**

Question 61

All would cause tinea to grow or expand EXCEPT? •A. Warm moist skin•B.Immunosuppression•C. Topical antibiotics•D. Topical steroids•

Answer 61

•A. Warm moist skin•B.Immunosuppression•**C. Topical antibiotics•D.** Topical steroids•

Question 62

The differential diagnosis of this eruption includes all EXCEPT? •A. Eczema•B. Tinea•C. Lupus•D. Lyme disease•E. All of the above

Answer 62

•A. Eczema•B. Tinea•C. Lupus•D. Lyme disease•**E. All of the above** Should do a KOH from the border area

Question 63

This lesion is loaded with neutophilic inflammation and fungal spores in the hair shaft. It is an example of : •A. A Carbuncle•B. A Furuncle•C. An Infected epidermal cyst•D. A Kerion•E. Acne keloidalis

Answer 63

•A. A Carbuncle•B. A Furuncle•C. An Infected epidermal cyst•D. **A Kerion**•E. Acne keloidalis

Question 64

THE ANCHORING FIBRILS OF THE BASEMENT MEMBRANE ZONE ARE MADE OF WHAT TYPE OF COLLAGEN?

Answer 64

Collagen VII

Question 65

WHAT IS THE MOST LIKELY DIAGNOSIS IN THIS ELDERLY ITCHY PATIENT? •A. BULLOUS IMPETIGO•B. PEMPHIGUS VULGARIS•C. DERMATITIS HERPETIFORMIS•D. EPIDERMOLYSIS BULLOSA SIMPLEX•E. BULLOUS PEMPHIGOID

Answer 65

Bullous Pemphigoid These are tense bulla. There is some surrounding erythema on the thigh. MARKED ITCH AND PATIENT AGE make bullous pemphigoid more likely than bullous impetigo. Pemphigus is characterized by flaccid, often eroded bulla.

Question 66

THE IMMUNOFLUORESCENT PATTERN SEEN HERE SUGGESTS A DIAGNOSIS OF WHAT? •A. PEMPHIGUS VULGARIS•B. BULLOUS PEMPHIGOID

Answer 66

•A. PEMPHIGUS VULGARIS•**B. BULLOUS PEMPHIGOID: LINEAR DEPOSITION OF IgG AT THE BASEMENT MEMBRANE ZONE**

Question 67

WHAT IS THE PRIMARY LESION IN THIS ELDERLY PATIENT WITH PEMPHIGUS VULGARIS? •A. MACULE•B. FLACID BULLA•C. TENSE BULLA•D. EROSION•E. PATCH

Answer 67

•A. MACULE•B. **FLACID BULLA•**C. TENSE BULLA•D. EROSION•E. PATCH

Question 68

THIS STRUCTURE CONTAINS THE BULLOUS PEMPHIGOID ANTIGENS AND INTEGRIN α6β4 •A. DESMOSOME•B. HEMIDESMOSOME•C. ANCHORING PLAQUE•D. LAMINA DENSA•E. SUB LAMINA DENSA•

Answer 68

•A. DESMOSOME•B. **HEMIDESMOSOME**•C. ANCHORING PLAQUE•D. LAMINA DENSA•E. SUB LAMINA DENSA•

Question 69

THIS STRUCTURE IS MADE OF TYPE VII COLLAGEN AND ANCHORS THE BASAL LAMINA TO THE PAPILLARY DERMIS •A. ANCHORING FIBRILS•B. HEMIDESMOSOME•C. PEMPHIGUS VULGARIS ANTIGEN•D. ANCHORING FILAMENTS•E. LAMININ•

Answer 69

**•A. ANCHORING FIBRILS**•B. HEMIDESMOSOME•C. PEMPHIGUS VULGARIS ANTIGEN•D. ANCHORING FILAMENTS•E. LAMININ•

Question 70

ALL THE FOLLOWING ARE PRIMARY LESIONS IN ACNE EXCEPT? •A. OPEN COMEDONES•B. PUSTULES•C. CYSTS•D. CRUSTS•E. CLOSED COMEDONES

Answer 70

•A. OPEN COMEDONES•B. PUSTULES•C. CYSTS•**D. CRUSTS**•E. CLOSED COMEDONES

Question 71

dx?

Answer 71

**Hidradenitis suppurativa** often occurs in the folds under the breasts, in the inguinal folds, axillary vault, or gluteal cleft. The distribution here is what is most characteristic of these inflammatory nodules.

Question 72

•“PRICKLY HEAT” associated with which? : * A. MILIARIA PROFUNDA * B. MILIARIA CRYSTALLINA * C. MILARIA RUBRA

Answer 72

Prickly Heat --\> Milaria Rubra

Question 73

Yellow papules ## Footnote associated with which? : * A. MILIARIA PROFUNDA * B. MILIARIA CRYSTALLINA * C. MILARIA RUBRA

Answer 73

Milaria Profunda

Question 74

Dew drops ## Footnote associated with which? : * A. MILIARIA PROFUNDA * B. MILIARIA CRYSTALLINA * C. MILARIA RUBRA

Answer 74

Milaria crystallina

Question 75

WHAT IS THE MOST LIKELY DIAGNOSIS IN THIS MIDDLE AGED WOMAN? •A. ACNE•B. ACNE FULMINANS•C. CYSTIC ACNE•D. SEBORRHEIC DERMATITIS•E. ROSACEA (GRANULOMATOUS)

Answer 75

•A. ACNE•B. ACNE FULMINANS•C. CYSTIC ACNE•D. SEBORRHEIC DERMATITIS•E. **ROSACEA (GRANULOMATOUS)** **Rosacea is more common in older woman, \>40 to 60, is symmetric, and characterized by erythema, telangiectasias, and papules. When the papules are firm and longstanding, the inflammation histologically may be granulomatous. This is a subset of rosacea.**

Question 76

dx?

Answer 76

**alopecia areata** The characteristic round patches of alopecia are without inflammation.

Question 77

dx?

Answer 77

alopecia universalis ## Footnote This is alopecia areata affecting the entire scalp, eyebrows, and eyelashes

Question 78

what's this?

Answer 78

Beau's Lines. sign of toxin or chemo in system

Question 79

dx?

Answer 79

melanoma

Question 80

dx?

Answer 80

•LENTIGO MALIGNA MELANOMA

Question 81

dx?

Answer 81

melanoma

Question 82

?

Answer 82

melanoma NOTE: this lesion demonstrates “A” and “B” of melanoma ABCD rule. This is the best choice of those above. It should be biopsied.

Question 83

WHAT IS THE BEST CLUE TO THE DIAGNOSIS OF MELANOMA ? •A. Erosion •B. Ulceration •C. Scaling •D. Pain •E. Blue black pigmentation near the erosion

Answer 83

Clues: pigment- blue/black near a glistening erosion.

Question 84

6. Using this instrument for examination of skin lesions is ● A.Dermatoscopy B.Magnifiscopy C.Melanomascopy D.Actinoscopy

Answer 84

● A.**Dermatoscopy** B.Magnifiscopy C.Melanomascopy D.Actinoscopy

Question 85

The most common location for this skin cancer in women is?

Answer 85

Legs ## Footnote Remember- the legs in women, the back in men are the most common locations. A complete skin exam includes these sites as well as the feet! Don’t forget or be lazy—take off the patient’s socks too and also look in the mouth and the scalp.

Question 86

A high percentage of patients with melanoma have this mutation •Keratin 5 and 14 •Tyrosinase •Lysyl hydroxylase •CDKN2A •Fibrillin

Answer 86

•Keratin 5 and 14 •Tyrosinase •Lysyl hydroxylase •**CDKN2A – codes for p16 and ARF** Tumor suppressor genes •Fibrillin

Question 87

THIS IS A CHILD WITH MULTIPLE ITCHY BROWN MACULES THAT URTICATE WITH STROKING. THE CELLS IN THE INFILTRATE ARE?

Answer 87

Mast cells

Question 88

A CHILD WITH A PAPULE THAT BLEEDS EASILY AND CAME UP AFTER A MILD TRAUMA.WHAT IS THE MOST LIKELY DIAGNOSIS?

Answer 88

pyogenic granuloma

Question 89

THIS LESION IS MADE UP OF?

Answer 89

Capillaries A pyogenic granuloma is a vascular tumor that often occurs in children, or in pregnancy. It is benign.

Question 90

MULTIPLE SKIN FOLD FRECKELS, THESE TUMORS, AND LISCH NODULES.WHAT IS THE DIAGNOSIS? •A. DYSPLASTIC NEVI •B. METASTATIC MELANOMA •C. SQUAMOUS CELL CARCINOMA •D. PYODERMA GANGRENOSUM •E. NEUROFIBROMATOSIS

Answer 90

•A. DYSPLASTIC NEVI •B. METASTATIC MELANOMA •C. SQUAMOUS CELL CARCINOMA •D. PYODERMA GANGRENOSUM •E**. NEUROFIBROMATOSIS**

Question 91

WHAT IS NOT ASSOCIATED WITH THIS DISEASE? •A. DYSPLASTIC NEVI •B. OPTIC GLIOMA •C. SKELETAL DYSPLASIA •D. NEW MUTATIONS CAUSE THE DISEASE IN 50% •E. LEARNING DISABILITIES

Answer 91

**•A. DYSPLASTIC NEVI** •B. OPTIC GLIOMA •C. SKELETAL DYSPLASIA •D. NEW MUTATIONS CAUSE THE DISEASE IN 50% •E. LEARNING DISABILITIES

Question 92

THESE FACIAL PAPULES ARE FOUND IN TUBEROUS SCLEROSIS. THEY ARE: ## Footnote A. NEUROFIBROMAS B.HEMANGIOMAS C.ANGIOFIBROMAS D. DERMOID CYSTS E. COMEDONES

Answer 92

A. NEUROFIBROMAS B.HEMANGIOMAS **C.ANGIOFIBROMAS** D. DERMOID CYSTS E. COMEDONES Skin findings in tuberous sclerosis include facial angiofibromas (adenoma sebaceum), periungual fibromas, connective tissue nevi (Shagreen patch), and hypopigmented macules (ash leaf macules). TS is an autosomal dominant condition characterized by hamartomas. Patients often present with seizures. Non-skin findings include neurological (seizures, developmental delay), eye (retinal hamartomas), renal (angiomyolipomas, polycystic kidneys), cardiac (rhabdomyomas), lungs (lymphangiomyomatosis).

Question 93

THIS IS A BENIGN PUSTULAR ERUPTION COMMONLY SEEN IN THE NEWBORN PERIOD. ## Footnote A. CUTIS MARMORATA B. ERYTHEMA TOXICUM C.ACRODERMATITIS ENTEROPATHICA D.HENOCH-SCHONLEIN PURPURA E. BIOTIN DEFICIENCY

Answer 93

A. CUTIS MARMORATA **B. ERYTHEMA TOXICUM** C.ACRODERMATITIS ENTEROPATHICA D.HENOCH-SCHONLEIN PURPURA E. BIOTIN DEFICIENCY Erythema toxicum neonatorum is a benign eruption seen in the neonatal period. It is usually diffuse in distribution. The palms and soles are rarely affected. It may last for up to 2 weeks.

Question 94

A WRIGHT OR GEIMSA STAIN OF THE PUSTULE FLUID WOULD SHOW THIS CELL IN ABUNDANCE ## Footnote A. EOSINOPHIL B. MAST CELL C. NEUTROPHIL D.LYMPHOCYTE E. BASOPHIL

Answer 94

**A. EOSINOPHIL** B. MAST CELL C. NEUTROPHIL D.LYMPHOCYTE E. BASOPHIL The cause of this condition is unknown. The diagnosis is usually based on the typical appearance and the skin smear filled with eosinophils. Erythema toxicum neonatorum is benign and spontaneously resolves within 3 weeks of life.

Question 95

THIS INFANT HAS DIARRHEA, THIS RASH, AND ALOPECIA. Order: A.SKIN CULTURE B.RAPID STREP ANTIGEN C.IMMUNOFLOURESCENCE OF SKIN D.SPINK5 MUTATIONAL ANALYSIS E.PLASMA ZINC LEVEL

Answer 95

A.SKIN CULTURE B.RAPID STREP ANTIGEN C.IMMUNOFLOURESCENCE OF SKIN D.SPINK5 MUTATIONAL ANALYSIS E.**PLASMA ZINC LEVEL** **This is an example of acrodermatitis enteropathica. This condition is due to zinc deficiency. There is usually periorificial dermatitis, acral dermatitis, and diaper dermatitis. All are characterized by some degree of erythema, scaling and erosion.**

Question 96

THIS IS HENOCH-SCHONLEIN PURPURA. THE LESIONS SEEN ARE: ## Footnote A. FULL OF GRAM NEGATIVE BACTERIA B. FULL OF GRAM POSITIVE BACTERIA C. GIANT CELL VASCULITIS D. LEUKOCYTOCLASTIC VASCULITIS DUE TO IGG IMMUNE COMPLEXES E. LEUKOCYTOCLASTIC VASCULITIS DUE TO IGA IMMUNE COMPLEXES

Answer 96

A. FULL OF GRAM NEGATIVE BACTERIA B. FULL OF GRAM POSITIVE BACTERIA C. GIANT CELL VASCULITIS D. LEUKOCYTOCLASTIC VASCULITIS DUE TO IGG IMMUNE COMPLEXES **E. LEUKOCYTOCLASTIC VASCULITIS DUE TO IGA IMMUNE COMPLEXES** In HSP, the affected child often develops arthralgias, abdominal pain, and may have renal involvement. Edema of the hands and feet may be a prominent finding. Children under three can have striking edema around the eyes, scalp, and ears. Patients with severe abdominal pain should be evaluated for intussusception with an abdominal ultrasound.