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A 3-year-old presents with rough, erythematous pruritic lesions on her cheeks and antecubital fossae. The family history is significant for asthma. Which of the following measures would be beneficial in the management of her condition?
A. avoid moisturizers
B. dehumidifier in bedroom
C.frequent bathing
D. wear cotton clothing

D. Cotton clothing is preferred for persons with atopic dermatitis. Wools and acrylics should be avoided, as they can exacerbate the condition.

1

A patient has a 4-mm flat lesion on her posterior lower thigh. It's color is variegated purple and black and it has well-demarcated margins. What is the preferred evaluation demarcated margins. What is the preferred evaluation method?
A. Excisional biopsy
B. KOH prep
C. Punch biopsy
D. Woods lamp assessment

A.
Any lesion suspected to be malignant melanoma must be biospied. Excisional biopsy is preferred, especially with small focal lesions. A lesion does not have to meet all criteria (ABCD) to be suspicious. (Pg PE-10)

2

An otherwise healthy 70-year-old presents with a painful vesicular eruption spread throughout the left mid lower back. Which of the following would best confirm the suspect diagnosis?
A. complete a Tzanck smear
B. measure IgG for varicella
C. obtain a fungal culture
D. perform PCR of skin scraping

D. Herpes zoster is typically a clinical diagnosis. If testing is deemed necessary, a PCR or direct immunofluoroscopy is the test of choice.

3

A 24-year-old generally healthy female presents with a concern about a rash on her face that began 2 months after initiating oral contraceptives. She denies history of diabetes or sun exposure. What is the most likely appearance of her rash?
A. diffuse brown areas of hyperpigmentation
B. round, atrophic, hyperpigmented lesions
C. small red or light brown macules
D. uniform pale brown macules varying in size

A. Melasma manifests as patterned hyperpigmentation areas of the face and is associated with estrogen such as during pregnancy or administration of estrogen-containing medications.

4

A 56-year-old male complains of a nonhealing lesion on his left cheek. Examination reveals a6-mm pearly papule with surface telangiectasias and a central erosion. What is the most appropriate next step in management?
A. curettage
B. electrodesiccation
C. excision
D. shave biospy

D. Shave biospy.
All lesions suspicious for basal cell carcinoma should undergo either shave or punch biospy prior to initiating curative treatment.

5

A 15-year-old boy with a history of allergic rhinitis presents complaining of recurrent pruritic skin lesions on his wrists and arms. Physical exam reveals generalized dry skin with scattered weepy red plaques and papules without scaling on the flexor surfaces of the wrists and antecubital fossae bilaterally. What is the most likely diagnosis?

Atopic Dermatitis (eczema) is a relapsing disorder characterized by underlying dry skin and pruritus. It is often associated with a personal or family history of atopy. Acutely lesions include erythematous patches and plaques with or without a scale. Lesions can erode and appear moist and crusted. Common sites of atopic dermatitis include the neck, eyelids, forehead, face, wrists, antecubital and popliteal fossae, hands and dorsa of the feet.