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Questions and Answers
What is the mainstay treatment for this severe form of acne vulgaris?
What is the mainstay treatment for this severe form of acne vulgaris?
What is the best antibiotic treatment if coverage for methicillin-resistant Staphylococcus aureus is needed?
What is the best antibiotic treatment if coverage for methicillin-resistant Staphylococcus aureus is needed?
Which of the following is a risk factor for developing lichen simplex chronicus?
Which of the following is a risk factor for developing lichen simplex chronicus?
What is the most likely diagnosis for a new-onset, swollen, pruritic rash that began as a few vesicles after gardening?
What is the most likely diagnosis for a new-onset, swollen, pruritic rash that began as a few vesicles after gardening?
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Which dermatologic condition is most likely to occur in a 19-year-old woman with polycystic ovarian syndrome?
Which dermatologic condition is most likely to occur in a 19-year-old woman with polycystic ovarian syndrome?
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What is the causative organism for tinea versicolor?
What is the causative organism for tinea versicolor?
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What is the most likely diagnosis of a lesion that is a slow-growing, erythematous nodule with a scaly appearance and ulceration?
What is the most likely diagnosis of a lesion that is a slow-growing, erythematous nodule with a scaly appearance and ulceration?
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Which of the following is a risk factor for melasma?
Which of the following is a risk factor for melasma?
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What is the most likely diagnosis for a variably pigmented macule with irregular borders that has been growing on a woman’s thigh?
What is the most likely diagnosis for a variably pigmented macule with irregular borders that has been growing on a woman’s thigh?
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What is the best choice for first-line treatment of psoriasis with approximately 3% body surface area affected?
What is the best choice for first-line treatment of psoriasis with approximately 3% body surface area affected?
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Which of the following is the best initial treatment for tinea versicolor?
Which of the following is the best initial treatment for tinea versicolor?
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Which cutaneous distribution of lesions differentiates the most likely disorder from other dermatoses?
Which cutaneous distribution of lesions differentiates the most likely disorder from other dermatoses?
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Which of the following additional findings is characteristic of the most likely diagnosis?
Which of the following additional findings is characteristic of the most likely diagnosis?
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Which of the following is the most likely diagnosis for pruritic bumps on the buttocks?
Which of the following is the most likely diagnosis for pruritic bumps on the buttocks?
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Which of the following mechanisms is likely responsible for the reaction and rash after sulfamethoxazole-trimethoprim?
Which of the following mechanisms is likely responsible for the reaction and rash after sulfamethoxazole-trimethoprim?
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Which of the following best describes the appearance of nummular eczema on physical exam?
Which of the following best describes the appearance of nummular eczema on physical exam?
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Which of the following is the most likely diagnosis for a pink, pearly papule with a rolled border?
Which of the following is the most likely diagnosis for a pink, pearly papule with a rolled border?
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Which of the following antibiotics is the best treatment for a patient with redness and swelling around the nail fold if methicillin-resistant Staphylococcus aureus needs to be covered?
Which of the following antibiotics is the best treatment for a patient with redness and swelling around the nail fold if methicillin-resistant Staphylococcus aureus needs to be covered?
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Which of the following is the best diagnosis for the thickened patch of skin on the anterior surface of the lower leg?
Which of the following is the best diagnosis for the thickened patch of skin on the anterior surface of the lower leg?
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Which of the following is the most likely diagnosis for swelling and tenderness over the proximal nail fold?
Which of the following is the most likely diagnosis for swelling and tenderness over the proximal nail fold?
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Which of the following is the most likely diagnosis for redness and flushing affecting the central face?
Which of the following is the most likely diagnosis for redness and flushing affecting the central face?
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Which patient population experiences an increased incidence of lichen planus?
Which patient population experiences an increased incidence of lichen planus?
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Which of the following treatment options is considered first line in the treatment of mild to moderate atopic dermatitis?
Which of the following treatment options is considered first line in the treatment of mild to moderate atopic dermatitis?
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Which factor is included in the ABCDE clinical prediction criteria for malignant melanoma risk?
Which factor is included in the ABCDE clinical prediction criteria for malignant melanoma risk?
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Which of the following is likely the first step in the pathogenesis of psoriasis?
Which of the following is likely the first step in the pathogenesis of psoriasis?
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Which of the following would be the initial test for a patient with sun-induced whitish patches?
Which of the following would be the initial test for a patient with sun-induced whitish patches?
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Which mechanism is most likely responsible for the pathogenesis of vitiligo?
Which mechanism is most likely responsible for the pathogenesis of vitiligo?
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What is the next best step for a melanoma diagnosis confirmed by biopsy?
What is the next best step for a melanoma diagnosis confirmed by biopsy?
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Which of the following is an appropriate second-line therapy for acne vulgaris?
Which of the following is an appropriate second-line therapy for acne vulgaris?
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Which of the following is the most likely diagnosis for raised lesions on elbows and knees with an overlying silvery scale?
Which of the following is the most likely diagnosis for raised lesions on elbows and knees with an overlying silvery scale?
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Which of the following is the most likely diagnosis for an itchy rash that followed a headache and sore throat?
Which of the following is the most likely diagnosis for an itchy rash that followed a headache and sore throat?
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Which of the following pharmacologic agents would be most effective in managing facial erythema in rosacea?
Which of the following pharmacologic agents would be most effective in managing facial erythema in rosacea?
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Which of the following diagnoses is likely for a woman with a new painful lesion on the right lateral forehead?
Which of the following diagnoses is likely for a woman with a new painful lesion on the right lateral forehead?
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Which genus of bacteria is most commonly associated with the development of acne vulgaris?
Which genus of bacteria is most commonly associated with the development of acne vulgaris?
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Which condition is best diagnosed as shown in the provided image?
Which condition is best diagnosed as shown in the provided image?
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Which medication is contraindicated in a pregnant patient with acne vulgaris?
Which medication is contraindicated in a pregnant patient with acne vulgaris?
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Which of the following is the most important prognostic factor for patients with malignant melanoma?
Which of the following is the most important prognostic factor for patients with malignant melanoma?
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Which of the following is the most common type of skin cancer in the United States?
Which of the following is the most common type of skin cancer in the United States?
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What finding differentiates rosacea from lupus erythematosus?
What finding differentiates rosacea from lupus erythematosus?
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Which of the following is the best treatment for an erythematous greasy-appearing rash on the central face?
Which of the following is the best treatment for an erythematous greasy-appearing rash on the central face?
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What is the mechanism of action for terbinafine used in the treatment of onychomycosis?
What is the mechanism of action for terbinafine used in the treatment of onychomycosis?
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What skin condition is known as 'the itch that rashes'?
What skin condition is known as 'the itch that rashes'?
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What skin condition is characterized by lichenified plaques in a flexural distribution?
What skin condition is characterized by lichenified plaques in a flexural distribution?
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Which of the following best describes the rash concerning for psoriasis seen in the patient?
Which of the following best describes the rash concerning for psoriasis seen in the patient?
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Study Notes
Patient Presentations with Skin Discoloration and Lesions
- 22-year-old man: Presented with hypopigmented, whitish, oval-shaped macules on his abdomen, likely tinea versicolor. Initial treatment: topical ketoconazole for two weeks.
- 42-year-old woman: Presented with a persistent, light pinkish-orange, slightly scaly annular patch on her lower abdomen resistant to topical antifungal. Developed new lesions, similar in color but smaller. History of influenza without antiviral treatment. Likely diagnosis: zosteriform distribution of lesions differentiates from other dermatoses.
- 40-year-old woman: Presented with purple, papular, pruritic, and polygonal rash on ankles and volar wrists. Characteristic of erythema migrans, but additional findings are not provided.
Patient Presentations with Skin Lesions and Conditions
- 25-year-old man: Presented with erythematous, pruritic, tender bumps on his buttocks, sometimes with pustules. Likely diagnosis: Staphylococcus aureus folliculitis.
- 27-year-old woman: Presented with a morbilliform rash (rash resembling measles) over her torso and extremities, improves with diphenhydramine. No hives, pustules, or petechiae; mucous membranes spared. Rash likely a reaction to sulfamethoxazole-trimethoprim. Mechanism: antigen exposure causing release of vasoactive substances.
- 24-year-old man: Presented with nummular eczema with round, erythematous, scaly plaques with raised borders. This condition is part of atopic dermatitis. Skin condition includes increased skin lines.
- 65-year-old woman: Presented with a 1cm pink, pearly papule on her face with rolled border and telangiectasia. Likely diagnosis: basal cell carcinoma.
- 27-year-old man: Presented with redness and swelling along the lateral nail fold of his index finger. Likely needs treatment for methicillin-resistant Staphylococcus aureus with antibiotics such as oral clindamycin.
- 32-year-old woman: Presented with well-demarcated erythematous plaques with silvery scales on elbows. Likely diagnosis: psoriasis.
- 30-year-old woman: Presented with uneven tanning after sunbathing. Whitish patches were seen under her arms and chest. Likely diagnosis of vitiligo. Initial treatment is antinuclear antibody testing.
- 35-year-old man: Presented with redness on forehead, cheeks, and nose with telangiectasias. Likely diagnosis is rosacea.
- 68-year-old man: Presented with a slowly-growing, 6 mm erythematous nodule on his face with scaly appearance and ulceration. Likely diagnosis is squamous cell carcinoma.
- 35-year-old woman: Presented with erythematous, well-defined, symmetric plaques on elbows and knees with silvery scale. History of similar lesions in family. Likely diagnosis of plaque psoriasis.
- 28-year-old woman: Presented with well-demarcated pale macules and patches on hands and near lips. Likely diagnosis of vitiligo.
- 72-year-old woman: Presented with painful yellowed toenail, with hyphae noted in potassium hydroxide preparation. Likely diagnosis of fungal nail infection (onychomycosis). Treatment is oral terbinafine.
- 67-year-old man: Presented with a 0.8 cm erythematous, tender papule with central hyperkeratosis on the forehead. Likely diagnosis is actinic keratosis which is different from squamous cell carcinoma, which has infiltration.
- A 19-year-old woman: Presented with increased serum androgen levels, likely due to polycystic ovarian syndrome. This may lead to acne vulgaris as a potential condition.
- A 68-year-old man: Presented with a slowly growing lesion on the face, with findings of a 6mm well-demarcated erythematous nodule with scaly appearance and ulceration, likely diagnosis is squamous cell carcinoma.
- A 28-year-old man: Presented with psoriasis, with erythematous plaques and silvery scales on anterior and posterior aspects of the torso. Likely needing topical medication such as betamethasone or tacrolimus.
Other Important Concepts
- Various risk factors: Factors like UV exposure, medications, and family history can play a role in skin disorders. For example, a history of influenza and lack of antiviral treatment could influence diagnosis.
- Diagnostic tests: Different tests (KOH prep, biopsy, etc.) are used to aid in diagnosis.
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Description
Test your knowledge on various skin conditions through detailed patient presentations. Each case provides unique symptoms and possible diagnoses, challenging you to identify the correct dermatological issues. Perfect for students and professionals in the medical and healthcare fields.
