Dermatology Quiz: Hyperpigmentation and Melasma

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Questions and Answers

Which treatment is NOT typically used for post-inflammatory hyperpigmentation?

  • Microdermabrasion
  • Cryotherapy (correct)
  • Chemical peels with salicylic acid
  • Topical retinoids

What is a primary characteristic of post-inflammatory hyperpigmentation (PIH)?

  • It always presents with severe inflammation.
  • It follows an injury or inflammatory disorder. (correct)
  • It is most common in individuals with fair skin types (Fitz 1-2).
  • It appears as hypopigmented macules and papules.

Which skin type is most likely to be affected by post-inflammatory hyperpigmentation?

  • Fitzpatrick skin type III
  • Fitzpatrick skin type IV (correct)
  • Fitzpatrick skin type I
  • Fitzpatrick skin type II

Which of the following best describes the typical appearance of melasma?

<p>Bilateral, asymptomatic, brown patches, common on the face. (A)</p> Signup and view all the answers

Which of the following is considered a risk factor for melasma?

<p>Use of estrogen-containing contraceptives (C)</p> Signup and view all the answers

What is the typical distribution of centrofacial melasma?

<p>Forehead, cheeks, nose, upper lip (A)</p> Signup and view all the answers

What is the typical timeframe for spontaneous resolution of post-inflammatory hyperpigmentation lesions?

<p>6-12 months (D)</p> Signup and view all the answers

Which of the following is an effective treatment for melasma?

<p>Sunscreen (D)</p> Signup and view all the answers

What is the primary concern regarding melasma treatment, even when successful?

<p>Reappearance of pigmentation upon sun exposure. (B)</p> Signup and view all the answers

Which of these is NOT a recommended treatment for melasma?

<p>Oral antibiotics (C)</p> Signup and view all the answers

Which best describes the appearance of lichen sclerosus on mucosal surfaces?

<p>Atrophic, white, and glistening with a wrinkled texture. (A)</p> Signup and view all the answers

Which area is least likely to be primarily affected by lichen sclerosus?

<p>The outer areas of the labia majora. (B)</p> Signup and view all the answers

What is a significant symptom of lichen sclerosus that can result in secondary skin changes?

<p>Extreme itchiness and soreness (D)</p> Signup and view all the answers

Which of the following is considered a possible etiological factor in lichen sclerosus, according to the text?

<p>Irritants. (B)</p> Signup and view all the answers

What is the significance of ECM-1 antibodies found in women with vulval lichen sclerosus?

<p>They suggest an autoimmune component to the disease. (C)</p> Signup and view all the answers

What is the typical ratio of female to male cases in lichen sclerosus?

<p>10:1 (A)</p> Signup and view all the answers

What characteristic defines vitiligo?

<p>Acquired depigmentation due to autoimmune destruction of melanocytes. (D)</p> Signup and view all the answers

Which topical treatment is likely to cause less stinging when applied for skin conditions?

<p>Ointment base topical steroid. (A)</p> Signup and view all the answers

How often should a topical steroid ointment be applied initially for treatment?

<p>Once a day. (B)</p> Signup and view all the answers

Which of the following is a systemic option for treating severe skin conditions when topical therapy fails?

<p>Intralesional corticosteroids. (A)</p> Signup and view all the answers

What is the expected duration for one 30-g tube of topical steroid to last with regular use?

<p>3 to 6 months. (A)</p> Signup and view all the answers

What is a common clinical characteristic of acanthosis nigricans?

<p>Velvety, hyperpigmented patches on the neck (A)</p> Signup and view all the answers

Which population shows the highest estimated prevalence of acanthosis nigricans?

<p>Native Americans (B)</p> Signup and view all the answers

Which of the following conditions is acanthosis nigricans predominantly linked to?

<p>Insulin resistance (C)</p> Signup and view all the answers

What type of growth factor receptors are involved in the pathology of acanthosis nigricans?

<p>Type 1 insulin-like growth factor receptors (C)</p> Signup and view all the answers

In rare cases, acanthosis nigricans may be associated with what serious condition?

<p>Internal malignancy (A)</p> Signup and view all the answers

What is the percentage of the population affected by vitiligo?

<p>1% (C)</p> Signup and view all the answers

Which diagnosis method highlights hypopigmented areas in vitiligo?

<p>Wood’s lamp (D)</p> Signup and view all the answers

What is the largest risk factor associated with vitiligo?

<p>Thyroid disease (D)</p> Signup and view all the answers

What is a common first-line treatment for vitiligo?

<p>Calcineurin inhibitors (B)</p> Signup and view all the answers

How often should whole-body or localized UVB phototherapy be administered for vitiligo?

<p>3 times per week (B)</p> Signup and view all the answers

What percentage of people with vitiligo may show a positive family history?

<p>30% (B)</p> Signup and view all the answers

What is the primary concern regarding the prognosis of vitiligo?

<p>It is associated with an increased risk for skin cancer (B)</p> Signup and view all the answers

Which systemic therapy may be used for quick stabilization of active vitiligo disease?

<p>Short pulse systemic steroids (A)</p> Signup and view all the answers

What is a common symptom of lichen sclerosus?

<p>Dysuria or anuria (A)</p> Signup and view all the answers

What age group is most often diagnosed with lichen sclerosus?

<p>Women over 50 (D)</p> Signup and view all the answers

What complication is associated with untreated lichen sclerosus?

<p>Increased risk of squamous cell carcinoma (D)</p> Signup and view all the answers

Which of the following is a recommended hygiene measure for managing genital lichen sclerosus?

<p>Wash with non-soap cleanser once or twice daily (D)</p> Signup and view all the answers

Which of the following might NOT be associated with a personal history affecting lichen sclerosus?

<p>Chronic allergies (A)</p> Signup and view all the answers

What characteristic describes the appearance of lesions associated with invasive squamous cell carcinoma in lichen sclerosus?

<p>Enlarging lump or sore that fails to heal (D)</p> Signup and view all the answers

What physical change can occur in the external genitalia due to lichen sclerosus?

<p>Burial of the clitoris (A)</p> Signup and view all the answers

Which statement is TRUE regarding the relationship between lichen sclerosus and other autoimmune diseases?

<p>Family history of autoimmune diseases may increase risk (B)</p> Signup and view all the answers

Flashcards

Acanthosis Nigricans

Velvety, thickened dark patches on skin, often in folds.

Etiology of Acanthosis Nigricans

Often linked to insulin resistance, obesity, and diabetes.

Prevalence of Acanthosis Nigricans

Common in 13.3% of African Americans and 5.5% of Latinos.

Clinical Presentation

Characterized by darkening and hyperkeratosis of skin.

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Malignant Acanthosis Nigricans

Rapid lesion development in non-obese middle-aged individuals; rare.

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Post-Inflammatory Hyperpigmentation (PIH)

Temporary skin pigmentation following injury or inflammation, commonly seen in darker skin types.

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Diagnosis of PIH

Usually clinical based on history and skin type; biopsy may be necessary.

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Treatment for PIH

Identify inflammation source, recommend sunscreen; can use skin lighteners and retinoids.

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Melasma

Hyperpigmented patches on the face or sun-exposed skin, asymptomatic with irregular borders.

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Common patterns of Melasma

Centrofacial (forehead, cheeks, nose), Malar (cheeks and nose), Mandibular (jawline).

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Risk factors for Melasma

Pregnancy, estrogen in contraceptives, hormonal therapy, and sun exposure increase chances of melasma.

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Pigmentation resolution in PIH

Lesions typically resolve spontaneously within 6-12 months but can be aided by treatments.

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Onset Age for Melasma

Melasma typically arises between ages 20-40, more common in women.

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Emollients

Substances applied to skin to relieve dryness and itching, acting as a barrier.

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Topical Steroids

Medications applied to the skin to reduce inflammation and symptoms of skin conditions.

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Clobetasol Propionate

A high potency topical steroid often used in treating severe skin conditions.

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Vitiligo

A skin condition characterized by depigmented macules and patches due to autoimmune destruction of melanocytes.

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Intralesional Corticosteroids

Corticosteroids injected directly into lesions to treat severe skin conditions.

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Dysuria

Painful or difficult urination often linked to urinary tract issues.

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Anuria

A condition where the body produces no urine.

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Lichen Sclerosus

A skin condition that affects the genital area, causing itching and pain.

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Cancer Risk in Lichen Sclerosus

Increased risk of squamous cell carcinoma in patients with untreated lichen sclerosus.

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Symptoms of Lichen Sclerosus

Includes itching, pain, and potentially fissures in the genital area.

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Biopsy in Lichen Sclerosus

A procedure to confirm diagnosis, especially for unhealing lesions.

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Treatment Measures

Gentle washing and using non-soap cleansers for managing lichen sclerosus.

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Family History and Lichen Sclerosus

Higher likelihood of lichen sclerosus in individuals with a family history of autoimmune diseases.

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Prevalence of Vitiligo

Affects about 1% of the population, often beginning before age 20.

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Etiology of Vitiligo

Association with stress, illness, or skin trauma; can also relate to thyroid disease.

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Diagnosis of Vitiligo

Utilizes Wood’s lamp and skin biopsy to detect absence of melanocytes.

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Prognosis of Vitiligo

Condition progresses slowly; risk of sunburns and skin cancer increases.

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First-line Treatment

Includes topical corticosteroids and calcineurin inhibitors for management.

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Second-line Treatment

Involves Ruxolitinib cream and phototherapy for more severe cases.

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Older Systemic Therapy

Includes short pulse therapy with systemic steroids to slow disease progression.

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Melasma Treatment

Methods to treat melasma include minimizing sun exposure and using broad-spectrum sunscreens.

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Oral Anti-Oxidants

Supplements like omega-3, omega-6, and Vitamin E support skin health in melasma treatment.

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Topical Treatments for Melasma

Topical agents like kojic acid, ascorbic acid, and hydroquinone are used to lighten pigmentation.

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Lichen Sclerosis Symptoms

Itchy and sore skin with atrophic white papules in lichen sclerosis.

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Lichen Sclerosis Etiology

Causes may involve genetic, hormonal, traumatic, and infectious factors leading to autoimmune responses.

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Female to Male Ratio in Lichen Sclerosis

The ratio is approximately 10:1, indicating a higher prevalence in females.

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Characteristics of Lichen Sclerosis

Features include ivory white papules with a smooth, atrophic surface on genital areas.

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Vulvar Lichen Sclerosis

Primarily affects the non-hair bearing areas of the vulva and can extend to other regions.

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