Podcast
Questions and Answers
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?
Which of the following is a risk factor for developing lichen simplex chronicus?
What is the most likely diagnosis for a patient with 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 and increased levels of serum androgens?
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What is the causative organism for tinea versicolor?
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What is the most likely diagnosis for a 68-year-old man with a 6 mm well-demarcated erythematous nodule with a scaly appearance and an area of ulceration on the face?
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Which of the following is a risk factor for melasma?
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What is the most likely diagnosis for a 35-year-old woman with a variably pigmented macule with irregular borders on her right anterior thigh?
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What is the best choice for first-line treatment of psoriasis affecting approximately 3% of total body surface area?
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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 in the 42-year-old woman from other dermatoses?
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Which of the following additional findings is characteristic of the most likely diagnosis in the 40-year-old woman with hepatitis C virus?
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Which of the following is the most likely diagnosis for the 25-year-old man with erythematous, pruritic bumps?
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What mechanism is likely responsible for the rash in the 27-year-old woman after antibiotic treatment?
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Which of the following best describes the appearance of skin on physical exam in a 24-year-old man with nummular eczema?
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Which of the following is the most likely diagnosis for the 65-year-old woman with a 1 cm pink, pearly papule?
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Which antibiotic is the best treatment for the patient with redness and swelling along the lateral nail fold if methicillin-resistant Staphylococcus aureus needs to be covered?
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What is the best diagnosis for the thickened patch of skin seen in the provided image?
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Which of the following is the most likely diagnosis for the 42-year-old woman with swelling and tenderness over the proximal nail fold?
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What is the most likely diagnosis for the 35-year-old man with facial redness and telangiectasias?
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Which patient population experiences an increased incidence of lichen planus?
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Which treatment option is considered first-line for mild to moderate atopic dermatitis?
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Which factor is included in the ABCDE clinical prediction criteria for melanoma risk?
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What is likely the first step in the pathogenesis of psoriasis in a patient with a new rash on both elbows?
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What would be the initial test for the condition in the 30-year-old woman with whitish patches?
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What is the most likely mechanism responsible for the pathogenesis of vitiligo in the 28-year-old woman?
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What is the next best step for the melanoma patient with a 1.5 millimeter thick lesion?
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What is an appropriate second-line therapy for acne vulgaris?
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Which condition is most likely diagnosed for the 35-year-old woman with raised lesions on her elbows and knees?
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What is the most likely diagnosis for the 20-year-old woman with an itchy rash after a recent sore throat and amoxicillin treatment?
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What is the most effective pharmacologic agent for managing facial erythema in the patient with persistent redness?
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What is the most likely diagnosis for the 45-year-old woman with an intensely pruritic rash on her hands?
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What presentation would be most likely identified on a 35-year-old man with HIV and recent antiretroviral therapy?
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Which historical aspect is most concerning for psoriasis in the 18-year-old man?
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What skin condition known as 'the itch that rashes' involves lichenified plaques?
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What is the most likely diagnosis for the 30-year-old man experiencing burning areas on his scalp and beard?
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Which antifungal would be most indicated for the patient with moderate onychomycosis?
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Which medication is absolutely contraindicated in a pregnant patient with worsening acne vulgaris?
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What is the most important prognostic factor for patients with malignant melanoma?
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What is the most common type of skin cancer in the United States?
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What finding differentiates rosacea from lupus erythematosus?
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What is the best treatment for the suspected diagnosis in a 20-year-old man with an erythematous greasy rash?
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What finding differentiates squamous cell carcinoma from actinic keratosis?
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Which genus of bacteria is most commonly associated with the development of acne vulgaris?
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What is the best diagnosis of the condition pictured above?
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What is the mechanism of action for terbinafine, prescribed for onychomycosis?
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Study Notes
Skin Discoloration and Lesions
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Case 1 (22-year-old man): Patches of skin discoloration, hypopigmented whitish oval macules on abdomen, noted after working as lifeguard. Diagnosis: Tinea versicolor. Treatment: Avoidance of irritants, topical ketoconazole applied daily for two weeks.
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Case 2 (42-year-old woman): Persistent, 2 cm light pinkish-orange, slightly scaly annular patch on right lower abdomen. Resistant to topical antifungal. More lesions developed, similar color, smaller, previously had influenza. Diagnosis: Differentiate other skin disorders via distribution pattern (zosteriform).
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Case 3 (40-year-old woman): Purple, papular, pruritic, polygonal rash on ankles and volar wrists (related to hepatitis C). Characteristic findings: Erythema migrans pattern involving palms and soles.
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Case 4 (25-year-old man): Erythematous, pruritic, tender bumps on buttocks, sometimes with pustules. Associated with sweating and poor hygiene. Diagnosis: Staphylococcus aureus folliculitis.
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Case 5 (27-year-old woman): Rash over entire torso and extremities, mild itchiness relieved with diphenhydramine. No new hygiene/cosmetic products. Associated with recent urinary tract infection (UTI). Reaction to antibiotic is suspected. Likely antibiotic-induced rash, resolving in one to two weeks. Mechanism: Antigen exposure causing release of vasoactive substances.
Skin Lesions (continued)
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Case 6 (24-year-old man): Nummular eczema: round, erythematous, scaly plaques with raised borders, central clearing. Note: This is a description of a skin condition, not a specific case.
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Case 7 (65-year-old woman): 1 cm pink, pearly papule with rolled border, telangiectasia below surface. History of tanning bed use. Diagnosis: Basal cell carcinoma. (Note: This is describing a skin lesion, not a full case.)
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Case 8 (27-year-old man): Redness and swelling along the lateral nailfold of index finger. Methicillin-resistant Staphylococcus aureus (MRSA) needs to be covered. Treatment: Oral clindamycin.
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Case 9 (Woman with lower leg patch): Thickened, discolored, and tougher patch of skin on lower leg. Associated with scratching due to underlying atopic dermatitis. Diagnosis: Lichen simplex chronicus.
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Case 10 (42-year-old woman): Pain and swelling of right middle finger, proximal nail fold. Diagnosis: Paronychia.
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Case 11 (35-year-old man): Redness to forehead and cheeks with telangiectasia.. Diagnosis: Rosacea (Note: This is describing a skin condition, not a specific case.)
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Case 12 (32-year-old woman): Erythematous plaques with silvery scales on elbows. Diagnosis: Psoriasis. Mechanism: Keratinocytes produce an inflammatory response, upregulation of dendritic cells, upregulation and differentiation of T cells.
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Case 13 (30-year-old woman): Sun-sensitive whitish patches under arms and chest. Only medication: oral contraceptive; recalls similar reaction in childhood. Test: Antinuclear antibody testing. Diagnosis was related to medications causing a new rash.
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Case 14 (28-year-old woman): Pale macules and patches between 1-4cm on hands and near lips. Diagnosis: Vitiligo. Mechanism: likely autoimmune in nature.
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Case 15 (60-year-old woman): Irregular borders and variegated color mole. Diagnosis: melanoma. Next step: Excision with wide margins.
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Case 16 (35-year-old woman): Erythematous, well-defined, symmetric, silvery scale lesions on elbows and knees; Family history of similar lesions, likely Psoriasis.
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Case 17 (20-year-old woman): Itchy rash; pink, oval-shaped patch with central clearing and scaly collar, especially in cleavage lines. Diagnosis: Pityriasis rosea.
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Case 18 (52-year-old woman): Persistent facial redness and flushing. Diagnosis: Rosacea. Treatment: Topical brimonidine or metronidazole.
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Case 19 (45-year-old woman): Intensely pruritic rash on hands, coming and going for 6 months. Diagnosis: likely Atopic Dermatitis.
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Case 20 (18-year-old man): 1-1.5 cm silvery, annular plaques around umbilicus and other sites. Concern for Psoriasis. Possible stressors, infection factor.
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Case 21 (35-year-old man): 0.8 cm erythematous, tender papule with central hyperkeratosis on right lateral forehead. Diagnosis: Squamous cell carcinoma vs. actinic keratosis (differentiate by infiltration).
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General point (repeatedly mentioned): History, physical exam, and skin lesion characteristics (e.g., shape, size, color, location, associated symptoms) are crucial for identifying skin disorders.
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Description
Explore a series of clinical cases that highlight various skin discolorations and lesions. This quiz covers diagnoses ranging from Tinea versicolor to conditions associated with hepatitis C. Test your knowledge on identifying skin disorders and their treatments.
