Hair, Nails And Mucous Membrane Disorders

Question 1

The nail is composed of what structures

Answer 1

Matrix, nail bed, hyponychium, cuticle, lunula, nail plate, eponychium

Question 2

Describe Beau’s Lines

Answer 2

Transverse depression of the nail plate or grooving that goes across the nails

Question 3

Beau’s Lines are found in what conditions

Answer 3

Zinc deficiency, lupus, psoriasis, serious illness/infection, trauma to the nailbed

Question 4

Oncholysis occurs when

Answer 4

Distal nail plate detaches

Question 5

Longitudinal melanoychia appears as what?

Answer 5

Brown-black bands due to melanin in the nail plate

Question 6

Nails that are extremely hard and difficult to trim are most likely due to

Answer 6

Pachonychia congentia

Question 7

Pachyonychia congenita is a very rare genetic disorder with what symptoms

Answer 7

Thickened nails, painful callouses and blisters on the bottoms of the feet and possibly the hands

Question 8

Twenty nail dystrophy is associated with what conditions

Answer 8

Amylodosis, alopecia areata, lichen planus, psoriasis, pemphigus vulgaris, Sarcoidosis

Question 9

Twenty nail dystrophy (trachyonychia) is described as what

Answer 9

Brittle nails with diffuse longitudinal ridging that can also have pitting, loss of Lustre or toughened nail plate

Question 10

Clubbing of the nail is associated with what condition

Answer 10

COPD

Question 11

A nail condition caused by frequent handwashing, detergent and water is

Answer 11

Onychoschizia - this is caused by frequent wetting and drying of the nails which leads to peeling of the nail plate layers

Question 12

Squamous cell carcinoma of the nail may present as

Answer 12

Hyperkeratosis, onycholysis, veruccal, paronychia, nail plate dystrophy or sugungual mass

Question 13

The ABCDEF of nail melanoma includes

Answer 13

Age of the patient, band of brown-black color, change in size or growth, digit (thumb, big toe or index finger usually affected), extension of color (Hutchinson sign) and family hx of melanoma

Question 14

First line pharmaceutical treatment of chronic paronychia is

Answer 14

High potency topical corticosteroids

Question 15

The hair growth cycle where hair growth and metabolic processes are decreasing and regression of the hair follicle is noted

Answer 15

Catogen

Question 16

Longest phase of the hair cycle, lasting 2 to 5 years, is when the hair is in the “growth phase”

Answer 16

Anagen

Question 17

Hair growth cycle where hair is in a resting phase. Usually lasts 3-4 months and ends with hair falling out.

Answer 17

Telogen

Question 18

Hair growth cycle where 50-100 hairs a day are shed from the scalp. This phase can last 2-5 months as new hair is growing into follicles

Answer 18

Exogen

Question 19

Non scarring alopecias

Answer 19

Alopecia areata, telogen effluvium, anogen effluvium, traction alopecia, androgenetic alopecia

Question 20

What medication is FDA approved for treatment of female pattern hair loss?

Answer 20

Topical 2% minoxidil

Question 21

Potential adverse reaction of finasteride

Answer 21

Erectile dysfunction

Question 22

The NP obtains a screening PSA on a 58 year old male who is taking finasteride for hair loss. She should know that when interpreting the PSA

Answer 22

The PSA level should be doubled yo obtain the accurate result

Question 23

A medication associated with the development of telogen effluvium is

Answer 23

Oral retinoid

Question 24

Diagnosis of telogen effluvium can be made when there is an increase in what percentage of telogen hairs

Answer 24

15%

Question 25

A moth eaten pattern of hair loss is suggestive of alopecia associated with

Answer 25

Syphillis

Question 26

Hair loss in a band-like pattern in the occupital/temporal areas of the scalp describes

Answer 26

Ophiasis

Question 27

The correct technique of intralesional corticosteroid in alopecia areata includes

Answer 27

Injecting outer edge of the hair loss

Question 28

Anthralin can cause

Answer 28

Staining of the skin

Question 29

Lichen planopilaris occurs most frequently in

Answer 29

Caucasians

Question 30

Frontal fibrosis alopecia is a subset of

Answer 30

Lichen planopilaris

Question 31

Folliculitis decalvans is most commonly associated with what organisms

Answer 31

Staphylococcus

Question 32

The most common bacterial agent responsible for paronychia

Answer 32

Staphylococcus

Question 33

Chronic paronychia is defined as inflammation of the nail fold that lasts longer than

Answer 33

6 weeks

Question 34

Approximately 80% of individuals with alopecia universalis will respond to use of systemic corticosteroids, however what percentage of individuals will relapse upon cessation of systemic corticosteroids?

Answer 34

50%

Question 35

The female to male ratio in Central centrifugal cicatricial alopecia is

Answer 35

3 to 1

Question 36

The treatment of central centrifugal cictricial alopecia is

Answer 36

Doxycycline 100 mg/day

Question 37

An inflammatory type of scarring alopecia associated with the development of sinus tracts describes

Answer 37

Dissecting Cellulitis of the scalp

Question 38

Sjogren syndrome diagnosis is often delayed

Answer 38

6-10 years

Question 39

Sjogren syndrome is usually managed by what specialty?

Answer 39

Rheumatology

Question 40

Sjogren syndrome symptoms are usually managed effectively with

Answer 40

Multiple strategies with mixed supporting evidence

Question 41

At presentation, the typical individual with sjogren syndrome is

Answer 41

Female and 40 years old

Question 42

First line treatment for lichen sclerosis includes

Answer 42

Long term high potency topical corticosteroids

Question 43

Incidence rates of lichen sclerosus are

Answer 43

Varied due to poor reporting but estimated between 1 in 300 and 1 in 1000

Question 44

One example of first line treatment for lichen sclerosus is

Answer 44

Clobetasol propionate 0.05% ointment BID for 1 month, once daily for 1 month then taper to 2x/weekly for a month

Question 45

Scarring in lichen sclerosus is found

Answer 45

In late disease

Question 46

Ocular symptoms occur in what percent of Behcet’s disease cases

Answer 46

90%

Question 47

Pathogenesis of behcet’s syndrome is

Answer 47

Autoinflammatory disorder with substantial host predilection

Question 48

Systemic therapy in treating behcet syndrome should be considered in

Answer 48

Patients with systemic symptoms

Question 49

A behcet syndrome patient that has ocular involvement. First line treatment considerations include

Answer 49

Cyclosporine, corticosteroids, azathioprine