dermatology

Question 1

black hairy tongue

Answer 1

aggressive oral hygiene-tongue brushing

Question 2

acne keloidalis nuchae

treatment
pseudofollicular barbae

Answer 2

firm, skin colored, pink, hyperpigmented papules centered on hair follicles, back of neck in people of color
antibiotics, steroids
hair bearing face and anterior neck

Question 3

psoriatic nails

tinea manuum

Answer 3

pitting, onycholysis (lifting of nail), oil drop sign

one hand and two feet

Question 4

pitted keratolysis
treatment

fungal feet infections

Answer 4

hyperhidrosis of feet, small pits on keratotic background
clindamycin/ erythromycin lotion, keep feet dry

web spaces

Question 5

steroid for eyelids (thin skin, also face, skin folds)

Answer 5

hydrocortisone valerate (low potency)

Question 6

contact allergy (to neomycin, for ex) vs infection

Answer 6

itchy, geometric pattern

Question 7

female androgenetic alopecia vs alopecia areata

Answer 7

decreased density at the top vs complete loss of hair

Question 8

Refractory/large/atypical warts

Answer 8

biopsy

otherwise destroy with cryotherapy, cantharidin, podophyllin, laser therapy, salicylic acid

Question 9

painless, LE wound surrounded by callus
treatment

tender with surrounding erythema

Answer 9

neuropathic ulcer
debride, remove, protect, treat infection

arterial

Question 10

rhus dermatitis

treatment

Answer 10

pruritic linear red papules and plaques, a vine (poison ivy, sumac, oak)
high potency steroid
ointments are better for burning sensation

Question 11

stasis dermatitis

cellulitis

Answer 11

red, inflamed, pitted skin, can be warm
compression stockings

erythema, pain, warmth, swelling, unilateral, leukocytosis, LAD, febrile

Question 12

dermatomyositis associated with

Answer 12

ILD, malignancy

heliotrope rash, knuckles, shawl sign

Question 13

basal cell carcinoma treatment

Answer 13

Mohs

Question 14

sun protection

Answer 14

SPF 15 or greater and UVA protection

Question 15

generalized pruritus without primary skin rash

Answer 15

CXR for Hodgkin lymphoma

med review

Question 16

scabies

Answer 16

interdigital spaces, body folds

Question 17

TEN vs SJS

treatment

Answer 17

<10% vs >30%

drug cessation, aggressive supportive ICU/burn center care

Question 18

cutaneous lupus

caused by

Answer 18

annular scaly patches on back and sun exposed areas, photosensitive, ANA, anti Ro/SSA +
hydrochlorothiazide

Question 19

pemphigus foliaceus

Answer 19

blisters, then crust over, cornflakes

Question 20

Hospital acquired skin and soft tissue infection

Answer 20

treat as MRSA

Question 21

A painful black eschar with slight surrounding angulated purpura in a patient on dialysis who has calcium and phosphorus abnormalities

treatment

Answer 21

calciphylaxis

dialysis, non calcium phosphate binders, sodium thiosulfate

Question 22

localized impetigo

Answer 22

mupirocin

Question 23

scaling plaques on trunk and proximal extremities after URI

Answer 23

pityriasis rosea, but also test for syphilis (affects palms and soles)

Question 24

Peristomal pyoderma gangrenosum

treatment

Answer 24

associated with IBD, in response to trauma such as surgery

potent steroid/cyclosporine/infliximab

Question 25

pretibial myxedema (Grave's)

Answer 25

thickening, firm but compressible plaques, shins, elephantiasis, severe deformity

Question 26

groups of itchy lesions

Answer 26

bedbugs

Question 27

Erythroderma caused by

Answer 27

Erythema of at least 80-90% of skin surface, edema, pruritus, scaling and LAD meds

Question 28

Hutchinson sign | management

Answer 28

zoster on forehead + lesion on nose | ophthalmology, antivirals+ steroid eye drops

Question 29

drug reaction with eosinophilia and systemic symptoms (DRESS)

Answer 29

morbilliform eruption, facial edema, fever, LAD skin eruption, hematologic abnormalities, lymphadenopathy, and internal organ involvement get CBC, BMP, give steroids

Question 30

Lichen sclerosis diagnosis treatment

Answer 30

white atrophic patches around anus and vagina, pruritus, dyspareunia biopsy high potency steroid-clobetasol, mometasone, or betamethasone

Question 31

fixed drug eruption

Answer 31

painful purple patch in the same place repeatedly, lips, genitals, hands NSAIDs, pseudoephedrine, antibiotics

Question 32

Sweet syndrome treatment

Answer 32

juicy, red papules, plaques or nodules with sharp borders, on trunk and proximal extremities, fevers, leukocytosis AML/ myelodysplastic syndrome steroids

Question 33

keratoacanthoma

Answer 33

volcano squamous cell carcinoma

Question 34

eosinophilic pustular folliculitis | associated with

Answer 34

intensely itchy, clustered on chest and face, eosinophilia | HIV infection

Question 35

fixed livedo reticularis + thromboses

Answer 35

antiphospholipid antibody syndrome

Question 36

red, pruritic plaques and wheals that last less than 24 hours after a probable viral upper respiratory tract infection

Answer 36

acute urticaria->cetirizine | no further testing/imaging

Question 37

seborrheic dermatitis (dandruff) treatment

Answer 37

ketoconazole

Question 38

preggo acne

Answer 38

azelaic acid cream, topical erythromycin

Question 39

herpes diagnosis

Answer 39

direct-fluorescent antibody and polymerase chain reaction testing, unroof, swab base

Question 40

miliaria crystalina | treatment

Answer 40

heat rash, lesions on back after immobilization | decrease sweating, cool baths, loose clothing

Question 41

migratory itchy plaque + beach | treatment

Answer 41

cutaneous larva migrans | ivermectin/ albendazole

Question 42

melanoma prognosis

Answer 42

lesion depth, elevated mitotic rate, ulceration

Question 43

subungual melanoma

Answer 43

black line on single nail black and Asian patients nail matrix biopsy

Question 44

porphyria cutanea tarda

Answer 44

liver damage->increased prophyrins in tissue skin fragility and small, transient, easily ruptured vesicles in sun-exposed areas such as on the hands, hypertrichosis, skin darkening

Question 45

urticarial vasculitis | diagnosis

Answer 45

last 3 days, leave bruises | skin biopsy

Question 46

RAST test-Radioallergosorbent testing

Answer 46

for allergies

Question 47

longstanding atopic dermatitis+ new pustules+ breakdown of skin

Answer 47

staph a (treat with mupirocin)

Question 48

post inflammatory hyperpigmentation due to acne

Answer 48

topical retinoid, can add hydroquinone later

Question 49

hand dermatitis caused by handwashing

Answer 49

emollient such as petrolatum

Question 50

dermatitis herpetiformis associated with

Answer 50

chronic, extremely pruritic, elbows, knees, buttocks, scalp, GI symptoms celiac disease

Question 51

cough+ facial rash after smoking cessation

Answer 51

sarcoid

Question 52

chronic cutaneous lupus first line systemic drug

Answer 52

topical steroids and tacrolimus fail->systemic hydroxychloroquine *prednisone for systemic lupus*