DERMATOLOGY

Question 1

Pustules of erythema toxicum contain

Answer 1

Eosinophils (reassurance)

Question 2

Pustules of transient neonatal pustular melanosis contain

Answer 2

Neutrophils (reassurance)

Question 3

Newborn with white papules on the hard palate

Answer 3

Epstein pearls (reassurance)

Question 4

An infant with small papules and pustules on the forehead, nose, and cheeks and an absence of comedones.

Answer 4

Neonatal acne (resolves without treatment)

Question 5

Newborn with white papules on the upper gums

Answer 5

Bohn nodules (reassurance)

Question 5

Newborn with pinhead white papules on the face

Answer 5

Milia (reassurance)

Question 6

Newborn with blistering and erosions of the skin. May have mucous membrane and nail
involvement. Infection has been ruled out

Answer 6

Epidermolysis bullosa

Question 7

What is the best diagnostic test for epidermolysis bullosa?

Answer 7

Skin biopsy of an induced blister or genetic
testing

Question 8

Well-defined erythematous plaques on the knees and elbows, covered with silvery scales, bleed when removed, pitting of the nails

Answer 8

Psoriasis

Question 9

Child with ulcerative colitis presents with bright
red, tender nodules on the anterior leg

Answer 9

Erythema nodosum

Question 10

Erythematous, scaly plaques in periorificial and
acral areas, alopecia, and diarrhea

Answer 10

Acrodermatitis enteropathica (zinc deficiency)

Question 11

A 2-year-old boy with fever, fragile blisters, and
denuded skin, predominantly affecting the flexures and perioral skin

Answer 11

Staph scalded skin syndrome (SSSS)

Question 12

Most common virus that triggers erythema
multiforme

Answer 12

Herpes simplex virus (HSV)

Question 13

Adolescent boy with a history of cold sores
presents with targetoid papules, distributed acrally, and hemorrhagic crusting of the lips

Answer 13

Erythema multiforme

Question 14

Child is taking penicillin for a dental abscess,
developed macules, papules, vesicles, bullae, and ulcerations on 8% of the body surface area.
Sloughing, blistering, and ulceration around the
lips, eyes, and genitalia are also present

Answer 14

Stevens–Johnson syndrome

Question 15

Poorly defined, hypopigmented rough macules and patches on the cheeks

Answer 15

Pityriasis alba

Question 16

Adolescent with oval scaly papules and plaques on the trunk that run parallel to skin cleavage lines

Answer 16

Pityriasis rosea

Question 17

Adolescent boy with hypopigmented scaly lesions on the neck, chest, and back that worsen with sun exposure

Answer 17

Tinea versicolor

Question 18

What is the cause of tinea versicolor?

Answer 18

Malassezia furfur

Question 19

Child with one bald spot on the scalp with scale
and “black-dot” hairs (the remnants of broken hairs within follicles). What is the best treatment?

Answer 19

Oral antifungal

Question 19

Child with an itchy rash affecting both feet. Exam shows scaling, fissuring, and maceration in the interdigital spaces. What is the best treatment?

Answer 19

Topical antifungal cream, e.g., terbinafine cream

Question 20

A young child with diffuse thinning of the hair on the scalp after undergoing major surgery 3 months prior

Answer 20

Telogen effluvium

Question 21

Child with one bald spot on the scalp with no
associated scale or redness. What is the best
treatment?

Answer 21

Reassurance or topical steroids (alopecia areata)

Question 22

Condition with pegged-shaped teeth, prominent
ears, small chin, frontal bossing, absence of
sweating with associated overheating

Answer 22

Hypohidrotic ectodermal dysplasia

Question 23

Female neonate with blistering and/or hyperpigmentation of the skin in a blaschkoid distribution. May be associated with eye and neurologic abnormalities

Answer 23

Incontinentia pigmenti (X-linked dominant)

Question 24

Fish-like scaling of the body, sparing flexural areas, with corneal opacities and history of cryptorchidism

Answer 24

X-linked recessive ichthyosis

Question 25

Extremities are covered with fine, irregular, polygonal scales, hyperlinear palms; worse with dry weather and during winter, family history of “dry skin”

Answer 25

Ichthyosis vulgaris

Question 26

A 3-year-old boy was exposed to poison ivy while playing in the garden. He developed itchy linear streaks of vesicles on both arms. What is the best treatment?

Answer 26

Topical steroids (Rhus dermatitis)

Question 26

Erythematous, scaly, itchy plaques in the antecubital and popliteal fossae, older brother with asthma

Answer 26

Atopic dermatitis

Question 27

What is the most important recommendation for all cases of contact dermatitis?

Answer 27

Avoidance of triggering agents

Question 28

Unilateral, irregular brown to blue-gray pigmentation of the neck, shoulder, supraclavicular, deltoid, and/or upper arm skin. May darken at puberty

Answer 28

Nevus of Ito

Question 29

Folliculocentric papules with central keratinous debris on the upper arms and thighs

Answer 29

Keratosis pilaris

Question 30

Unilateral, irregular, blue-gray discoloration in the periorbital area and sclera (Ocular)

Answer 30

Nevus of Ota

Question 31

A nevus of Ota involving the sclera requires monitoring by ophthalmology due to increased risk of

Answer 31

Glaucoma > ocular melanoma

Question 32

Large congenital nevi likely carry an increased risk of what type of cancer?

Answer 32

Melanoma

Question 33

Child is going to the beach for swimming and parents are concerned about sunburn. How would you counsel the family about sunscreen use?

Answer 33

Apply SPF 30 or greater sunscreen 15–30 min before sun exposure, reapply every 2 h

Question 34

Large facial port-wine stain involving V1, seizures, and glaucoma

Answer 34

Sturge–Weber syndrome

Question 35

Posterior fossa malformations (Dandy–Walker), hemangiomas, arterial anomalies, cardiac defects (e.g., coarctation of the aorta), and eye abnormalities

Answer 35

PHACE syndrome

Question 36

An infant with a large hemangioma on the upper eyelid is at risk for

Answer 36

Amblyopia

Question 37

What is the best treatment for a hemangioma on the upper eyelid that obstructs the visual axis?

Answer 37

Oral propranolol

Question 38

Annular plaque without scale not responding to topical antifungals

Answer 38

Granuloma annulare

Question 39

An infant with a 4-month history of seborrheic dermatitis-like rash on the scalp, behind the ears, and in the diaper area not responsive to topical antifungals or steroid cream

Answer 39

Langerhans cell histiocytosis

Question 39

An infant with orange to brown macules and papules that become red and swollen when stroked

Answer 39

Urticaria pigmentosa (cutaneous mastocytosis)

Question 40

A 12-year-old boy with learning disabilities and seizure disorder presents with persistent papules on the face despite acne treatment. He is also found to have hypopigmented skin lesions on the exam

Answer 40

Tuberous sclerosis

Question 41

A 10-month-old with light brown macules and small patches on the body. How many café-au-lait macules should raise concern for neurofibromatosis?

Answer 41

Six

Question 42

What is the treatment for head lice?

Answer 42

Permethrin 1% liquid; 2 treatments spaced 1 week apart

Question 43

What is the treatment for scabies?

Answer 43

Permethrin 5% cream; 2 treatments spaced 1 week apart