Dermatology

Question 1

Multiple failed treatments for scabies

Answer 1

Infantile acropustulosis

intensely pruritic papulopustular lesions

tx: topical steroids and antihistamines

Question 2

Staph Scalded Skin Syndrome vs. TEN/Steven Johnsons

Answer 2

SSSS: Plane of cleavage is higher, in the epidermis. Thin walled bullae

TEN/SJS: cleavage is at the basement membrane, thick walled bullae

Question 3

Answer 3

Langerhans Cell Histocytosis

+/- systemic disease

non healing diaper dermatitis

hepatosplenomegaly,, FTT, lymphadenopathy, crhonically draining ears

Biosy: langerhans granules within cytoplasm of infiltrating cells

Question 4

Answer 4

Scabies

tx: topical permethrin, x 2 courses (adult lice and 2nd for hatched eggs)

Question 5

Answer 5

Serum sickness

urticarial lesions, periarticular swelling, extremity angioedema

nonpruritic

migratory stocking glove angioedema

Question 6

Answer 6

Nevus sebaceus of Jadassohn

hairless, well circumscribed skin/yellow/orange waxy plaque

Question 7

Answer 7

Infantile atomic dermatitis , birth-6months

ie eczema.

spartes diaper area

Question 8

Answer 8

Scabies mites and eggs

Question 10

Answer 10

Urticaria pigmentosa

reddish-brown lesions, hyperpigmentation

cutaneous mastocytosis

Darrier sign: wheal and flare after stroking

Question 11

Papular urticaria

severe, excoriated, papular reaction developed in response to recurrent flea bites

highly pruritic

Question 12

Answer 12

Henoch Schonlein purpura

Question 13

Answer 13

Pyogenic granuloma

benign vascular tumors, stem from grannulation tissue following foreing body/minor trauma

onset well after newborn period

Question 14

Answer 14

Pityriasis rosea

Question 15

Answer 15

Job syndrome

pruritic dermatitis (elevated IgE)

Question 16

Answer 16

Auspitz sign

removal of psoriasis scale produces small points of bleeding from tortuous capilaries

Question 17

KOH scraping

Answer 17

Candidal diaper dermatitis

pseudohyphae and spores

Question 18

Answer 18

Guttate psoriasis

small droplike plaques with typical scales forllowing strep infection

Question 19

Answer 19

Staphylococcal diaper dermatitis

thin walled pustules, erythamtous halos, collarette of scale

Question 20

Answer 20

Granuloma annulare

NON pruritic, no scale

Question 21

Answer 21

Psoriasis

Question 22

Answer 22

Tinea versicolor

“spaghetti and meatballs” combination of hyphal and yeast forms

Question 23

Answer 23

Ichthyosis vulgaris

Autosomal dominant

thick dry fish like scales

Question 24

Answer 24

Lichen striatus

flat topped papules appearing in a linear or swirled districution along the lines of Blaschko

Self resolving, 1-3yrs

Question 25

Answer 25

Erythema multiforme commonly soles, palms, extensor surfaces

Question 26

Answer 26

Lichen Planus flat topped, pruritic polygonal violaceous papules and plaques dorsal surfaces tx: topical steroids

Question 27

Answer 27

Mastocytoma solitary reddish-brown plaque postivie darier sign: after stroking, wheal and flare

Question 28

Answer 28

Pityriasis alba common in atopic dermatitis patients poorly defined hypopigjmented, round scaly patches not wood lamp enhancing

Question 29

Answer 29

Juvenile Xanthogranuloma infiltration and proliferation of histiocytes if multiple lesions: refer to Ophtho, can be associated with hyphema

Question 30

Answer 30

Nummular Eczema annular/coin shaped

Question 31

Answer 31

Tinea versicolor caused by pityrosporum Color change with Wood's lamp topical therapies (selenium sulfide, azoles)

Question 32

KOH scrapings reveal the following

Answer 32

Tinea corporis fungal hyphae seen as long septate branching rods at the margins and center of the scales

Question 33

Answer 33

Tzanck preparation multinucleated giant cell--\> HSV or VZV

Question 34

Answer 34

Tinea corporis, "ringworm" Oral therapy (griseofulvin) when multiple lesions

Question 35

Answer 35

X linked Ichthyosis males "dirty brown", generalized scales increased risk for undescended testes, testicular cancer

Question 36

Answer 36

Dyshidrosis chronic cracking, oozing,scaling after intiial tiny pruritic vesicles have been scratched palms, soles, lateral fingers and toes "tapioca" papules

Question 37

Answer 37

Neonatal lupus erythematousis annular rash and tissue infarction (right ear pinna) thrombocytopenia, hypocomplementemia and elevated transaminases ANA and AntiRo positive

Question 38

Answer 38

Lanellar Ichthyosis most severe collodion membrane flexural areas involved, eversion of eyelids and lips

Question 39

Answer 39

Blistering distal dactylitis tense blister filled with purulent fluid Group A strep larger size of initial vesicles compared to herpetic whitlow

Question 40

Answer 40

Incontinentia pigmenti linerarly distributed vesicles, warty papules, swirls and streaks X linked dominant disorder, predominantly females (males lethal) along lines of blaschko CNS abnormalities,