Week 2

Question 1

Domed Papule with a keratin filled center (Volcanic Appearance)
- Tx:

Answer 1

Keratoacanthoma

• Surgical excision
• Progresses quickly, similar looking to SCC

Question 2

Benin capillary hemangioma, very friable, glistening red papule

Answer 2

Pyogenic granuloma, friable looking.

Question 3

Non-scaling, ropy border, central clearing. Looks a little like tinea corporis but without the scaling.. (picture of foot)

Answer 3

Granuloma annulare

Question 4

Targetoid rash, associated with tick bites

• Microbio bug
• Skin condition
• Tx

Answer 4

• Borrelia Burgdorferi
• Erthema MIGRANTS
• Can continue to lyme disease with bilateral bells palsy, etc.
• Tx: Amoxicillin or doxycycline

Question 5

Erythema nodosum

- Microbio bug

Answer 5

Streptococcal infection is common, also seen with fungal infections (sketchy = specifically the systemic ones such as histoplasmosis, blastomycosis, coccidiomycosis, paracoccidiomycosis)
- On the shins!

Question 6

Cancer with red scaly patch, central ulceration (umbilication) and PEARLY border

Answer 6

Basal Cell Carcinoma!

Question 7

Skin cancer associated with smoking and therefore can present with cancer of the lip

Answer 7

Squamous Cell Carcinoma

Question 8

3 types of basal cell carcinoma

- Nodular, Superficial, and Morpheaform

Answer 8

Nodular = nodular. Blah.

Superficial = flat, pink, etc.

Morpheaform = high rate of recurrence, overlying telangectasia

Question 9

BCC: Which epidermal layer?

Answer 9

Basal layer

Question 10

Best treatment option for high risk areas like Face, eyes, and ears.

Answer 10

Mohs

Question 11

“Stuck on” lesions, looks like you can just peel it off

Answer 11

Seborrheic Keratoses

• AKA basal cell papilloma or verruca senilis
• cystic inclusions of HORNY material (keratin horns)

Question 12

Benign Neoplasm that is centrally umbilicated. Crater is lined by glassy, proliferating keratinocytes that invade the dermis

Answer 12

Keratoacanthoma

Question 13

Pre Squamous Cell Carcinoma

2

Answer 13

AK - Actinic (solar) Keratosis
- Scaly erythematous patches and plaques. Hyperchromatic nuclei.

Leukoplakia
- Associated by EBV and HIV

Question 14

Pearly papule, will see basophilic cells on histology

Answer 14

Basal Cell Carcinoma

• Most common malignant tumor
• Cancer of the basal layer
• Cubodial epithelium

Question 15

Cancer of the epidermis whose cells typically resemble keratinocytes.

Answer 15

Squamous Cell Carcinoma

Question 16

Most common cancer in men of India

Answer 16

Oral Squamous Carcinoma

Question 17

Skin condition seen in Insulin resistance as well as several internal malignancies.
- What is the treatment

Answer 17

Acanthosis Nigricans

- Treat underlying cause!

Question 18

Treatment for verrucae

Answer 18

Warts, caused by HPV

- Salicylic acid is first line (liquid nitrogen too which is also used for seborrheic keratosis

Question 19

Medical term for skin tags

Answer 19

acrdochordons

Question 20

Umbilicated PAPULES that are NEVER found on the palms or soles.

Answer 20

Molluscum Contagiosum (part of pox virus family)

Question 21

yellow cholesterol plaque present on eyelids

- Associated with familial _____

Answer 21

Xanthelasma, associated with hyperlipidemia

Question 22

Generalized Papules and Plaques: two of the Cutaneous T-Cell Lymphoma

Answer 22

Mycosis Fungoides and Sezary syndrome

Question 23

• Mycosis fungoides, will see _______ on biopsy

- Sezary Syndrome

Answer 23

• Mycosis Fungoides: atypical mononuclear cells invading upper epidermis (because it is a T-cell lympoma)
• Sezary syndrome: Circulating Sezary cells (atypical lymphocytes with cerebriform nuclei)

Question 24

Associated with Wickham’s striae (buzzword)

- Associated with Hep C

Answer 24

Lichen Planus

• White, lacelike pattern on the surface of the lesions or in the oral mucosa
• Associated with Hep C

Question 25

Characteristics Lichen Planus

Answer 25

5 Ps = Pruritic, purple, planar, polygonal, and papules

Question 26

Sarcoidosis: will see __________ in biopsy

Answer 26

noncaseating granulomas | - It is a granulomatous disease that affects many organs, under 40, and more common in African-American

Question 27

Salmon colored plaques with a silvery scale on extensor surfaces =

Answer 27

Psoriasis | - Will see elongation of rete ridges and dermal papillae

Question 28

Psoriasis: Clinical presentation (two specific presentations) + one rare presentation

Answer 28

Koebner phenomenon = lesions in sites of trauma from scratching (STAR) Auspitz sign = punctate bleeding if scales removed. Note: psoriatic arthritis!

Question 29

Pathogenesis of psoriasis

Answer 29

Autoimmune disease with persistent epidermal hyperplasia = rapidly dividing epidermal (3-4 days vs 28 days)

Question 30

Treatment for pemphigus vulgaris

Answer 30

Systemic steroids => Glucocorticoids

Question 31

Pemphigus vulgaris has a ____________ sign

Answer 31

Postive Nikolsky's sign | - Rubbering periphery of blister and having a separation of skin layers

Question 32

(+) Nikolsky's sign is positive in... (3)

Answer 32

Staph scalded skin syndrome, TEN, Pemphigus Vulgaris

Question 33

Dx of Bullous Pemphigoid + area of separation

Answer 33

Separation: level of basement membrane | - Dx: Biopsy and Immunofluorescent staining with negative Nikolsky's sign

Question 34

Associated with Celiac disease (hence the reason why tx is Gluten Free Diet)

Answer 34

Dermatitis herpetiformis

Question 35

Dermatitis Herpetiformis Tx (2)

Answer 35

Dapsone and Gluten Free Diet

Question 36

Dermatitis Herpetiformis is _____ mediated and located in the _______ dermis.

Answer 36

IgA mediated, and located in the papillary dermis.

Question 37

The pruritic rash you had on your skin

Answer 37

Dyshidrotic Eczema

Question 38

Hot Tub folliculitis is associated with ________

Answer 38

pseudomonas aeruginosa

Question 39

Which autoimmune bullous disorder have IgG antibodies and which one has IgA antibodies

Answer 39

Pemphigus Vulgaris = IgG antibodies against keratinocyte antigen Bullous Pemphigoid = IgG antibodies in the basement membrane Dermatitis Herpetiformis = IgA antibodies in the dermal papillae

Question 40

Autoimmune Bullous Disorders: separation of the entire epidermis at the dermoepidermal junction therefore doesn't rupture easily (tense)

Answer 40

Bullous pemphigoids

Question 41

Autoimmune Bullous Disorders: Oral mucosa is not affected

Answer 41

Dermatitis herpatiformis

Question 42

Anti-Jo-1 antibodies are seen in....

Answer 42

dermatomyositis

Question 43

Associated with Ash leaf spot and the classical triad of seizure, intellectual disability, and favial angiofibromas

Answer 43

Tuberous Sclerosis | - Brain lesions characteristic of TSC = cortical tubers

Question 44

See helitrope rash on the eye lids, Shawl sign around the shoulders, and Gottron's sign over the finger joints...

Answer 44

Dermatomyositis | - Also have Anti-Jo-1 antibodies + proximal muscle weakness

Question 45

What diseases are seen with pretibial subcutaneous nodules (Erythema nodosum)

Answer 45

Ulcerative Colitis and Crohn's + strep infections are common.

Question 46

Has elevated ESR lab value

Answer 46

psoriasis