Dermatology Quiz: Branch Of Medicine

The prognosis of malignant melanoma is based on the depth of the lesion. The depth of the lesion, also known as the Breslow thickness, is a crucial factor in determining the stage and prognosis of melanoma. Deeper lesions are more likely to have spread to nearby lymph nodes or other parts of the body, indicating a worse prognosis. Therefore, assessing the depth of the lesion is essential in predicting the outcome and planning the appropriate treatment for patients with malignant melanoma.

liver cirrhosis to be more specific

Molluscum contagiosum is the most likely diagnosis in this case. Molluscum contagiosum is a viral skin infection that commonly affects children and young adults. It is characterized by small, flesh-colored papules with a central depression or "cheesy" core. The papules are usually found on the trunk and extremities. Seborrheic keratosis is a benign skin growth that typically appears in older adults and is not associated with a cheesy core. Tinea corporis is a fungal infection that causes a ring-shaped rash, while keratoacanthoma is a type of skin cancer that presents as a rapidly growing dome-shaped nodule.

The most likely diagnosis for a 41-year-old male with "sausage digits," asymmetric stiffness in some fingers, nail pitting, and a history of heart disease is Psoriatic arthritis. Psoriatic arthritis is a type of inflammatory arthritis that occurs in some individuals with psoriasis. It can cause joint pain, swelling, and stiffness, as well as nail changes. The presence of nail pitting and asymmetric stiffness in the fingers suggests an inflammatory arthritis, and the patient's history of psoriasis and heart disease further supports the diagnosis of Psoriatic arthritis. Inverse psoriasis, VonZumbush psoriasis, and palmoplantar pustular psoriasis do not typically present with the same combination of symptoms as described in the question.

The crusted form of impetigo is commonly due to S.pyogenes, which is the organism responsible for causing the infection. The common clinical presentation of this form of impetigo is "honey colored" crusts on the skin.

The Auspitz sign refers to the occurrence of pinpoint bleeding when a scale is peeled back. This sign is commonly seen in conditions such as psoriasis, where the skin is thickened and scales are present. The pinpoint bleeding occurs due to the disruption of tiny blood vessels within the skin when the scale is removed. This sign is named after Heinrich Auspitz, an Austrian dermatologist who first described it in the 19th century.

Bullous pemphigoid is an autoimmune disorder characterized by the production of autoantibodies against components of the skin basement membrane. These autoantibodies cause inflammation and damage to the skin, leading to the formation of blisters and bullae. The immune system mistakenly targets the body's own tissues, resulting in an autoimmune response. This explanation aligns with the answer choice "autoimmune."

The most likely diagnosis for the 28-year-old male with patches of hypopigmentation on his back, which were first noticed at the beach during summer break, is tinea versicolor. The causative agent responsible for this condition is Malassezia furfur. Tinea versicolor is a fungal infection caused by Malassezia furfur, which is a type of yeast. This condition is characterized by patches of hypopigmentation on the skin, which may be more noticeable after sun exposure. The positive KOH prep supports the diagnosis of tinea versicolor, as it helps to identify the presence of fungal elements.

The most likely diagnosis for this patient is seborrheic dermatitis. Seborrheic dermatitis is a common chronic inflammatory skin condition that primarily affects the scalp and face. It is characterized by erythema (redness) and yellowish eczematous scaling rash. The patient's age and symptoms are consistent with seborrheic dermatitis, and the negative KOH prep rules out tinea capitis, a fungal infection. Drug eruption and rosacea are less likely given the patient's presentation and medical history.

The patch test is considered the gold-standard diagnostic test for contact dermatitis. This test involves applying small amounts of potential allergens onto the patient's skin, usually on their back, and leaving them in place for a period of time. If the patient develops a reaction at the site of application, it indicates that they are allergic to that particular substance. This test is highly specific and helps identify the specific allergens causing the dermatitis, allowing for targeted treatment and avoidance measures. Clinical presentation, KOH, and Wood's light may provide additional information but are not as reliable or specific as the patch test in diagnosing contact dermatitis.

Melasma is the most likely diagnosis in this case. Melasma is a common skin condition characterized by patchy, brown, macular pigmentation on the face, particularly on the malar surface. It is often triggered by hormonal changes, such as those caused by oral contraceptives. The patient's denial of changes to her cosmetic routine or recent burns further supports the diagnosis of melasma. Contact dermatitis, actinic keratosis, and drug eruption are less likely based on the given information.

Lichen Simplex Chronicus = AKA Neurodermatitis

Wood's light is the diagnostic test used to enhance examination if one suspects vitiligo. Wood's light is a handheld ultraviolet lamp that emits black light. When the light is shone on the skin, it helps to highlight the areas of depigmentation in vitiligo. These areas appear as white patches under the Wood's light, making it easier for a healthcare professional to diagnose the condition. This test is non-invasive and painless, making it a useful tool in the diagnosis of vitiligo.

The Sign of Lesar-Trelat refers to the sudden and rapid increase in the size and number of seborrheic keratosis (SK) lesions. Seborrheic keratosis is a common benign skin growth that appears as brown to black-colored papules. However, when there is a sudden increase in the size and number of these lesions, it can be indicative of an underlying malignancy, particularly gastrointestinal adenocarcinoma. Therefore, the Sign of Lesar-Trelat serves as an important clinical clue for further investigation and evaluation of possible malignancy.

Accutane is classified as a Category X medication for the treatment of acne vulgaris. Category X medications are contraindicated for use in pregnant women due to their potential to cause fetal harm. Accutane contains isotretinoin, a powerful medication that can cause severe birth defects if taken during pregnancy. Therefore, it is important for women of childbearing age to use effective contraception while taking Accutane.

The most likely diagnosis for the patient's condition is Verruca Vulgaris. Verruca Vulgaris, commonly known as a common wart, is a viral infection caused by the human papillomavirus (HPV). It typically presents as skin-colored papules with a hyperkeratotic surface. In this case, the papules are found on the hands and fingers, and some extend underneath the nail bed. The negative KOH prep suggests that it is not a fungal infection like Tinea unguium or Onychomycosis. Paronychia, an infection of the nail fold, is less likely given the presentation and the patient's occupation as a butcher.

The likely diagnosis for the 34-year-old female presenting with painful, grouped, abscesses and acneiform lesions under her arms, buttocks, and inner thigh is Hidradenitis Suppurativa. This condition is characterized by chronic inflammation of the hair follicles and sweat glands, leading to the formation of painful nodules, abscesses, and sinus tracts. It commonly affects areas with apocrine sweat glands, such as the axilla, groin, and buttocks. Risk factors for Hidradenitis Suppurativa include smoking and hormonal factors, such as oral contraceptive use. Folliculitis, Intertrigo, and Acne vulgaris do not typically present with the same distribution and severity of symptoms as seen in this case.

Paronychia is the correct answer because it refers to the inflammation of the nail fold, which is characterized by erythema (redness) and edema (swelling). It is commonly associated with thumb suckers, as the constant moisture can create a favorable environment for bacterial or fungal infections. Tinea unguium refers to a fungal infection of the nails, onychomycosis is another term for the same condition, and periunguium is not a recognized medical term for this condition.

The patient's symptoms, including fever, chills, headache, and the presence of maculopapules on the wrist and ankles, are consistent with Rocky Mountain Spotted Fever (RMSF). The laboratory results of thrombocytopenia, proteinuria, and hematuria further support this diagnosis. The patient's recent travel to the western region also aligns with the geographic distribution of RMSF. The causative agent of RMSF is Rickettsia rickettsii, a bacterium transmitted through the bite of infected ticks.

Renal transplant patients have a weakened immune system due to the use of immunosuppressive medications, which makes them more susceptible to developing squamous cell carcinoma. These medications suppress the immune system's ability to fight off cancer cells, leading to an increased risk of developing this type of cancer. Therefore, squamous cell carcinoma is more common in patients with a preexisting condition of renal transplant.

Seborrheic Keratosis is not associated with UV exposure. Seborrheic Keratosis is a common noncancerous skin growth that appears as a brown, black, or tan growth on the surface of the skin. It is believed to be caused by a combination of genetic and environmental factors, but UV exposure is not one of them. Actinic Keratosis, Keratoancanthoma, and Melasma, on the other hand, are all conditions that can be triggered or worsened by UV exposure. Actinic Keratosis is a precancerous skin condition, Keratoancanthoma is a type of skin cancer, and Melasma is a skin condition characterized by dark patches on the skin.

The correct answer is "tumor, edema". Cellulitis is a bacterial skin infection that can cause inflammation and swelling. One of the signs of cellulitis is the presence of a tumor, which refers to an area of swelling or a lump. Edema, on the other hand, refers to the accumulation of fluid in the affected area, which contributes to the swelling. Therefore, the presence of a tumor and edema are indicative of cellulitis.

Acanthosis nigricans Type 2 is associated with endocrine disorders. This condition is characterized by dark, thickened patches of skin, usually in the folds and creases of the body. It is commonly seen in individuals with insulin resistance or hormonal imbalances, such as those with polycystic ovary syndrome or Cushing's syndrome. These endocrine disorders disrupt the normal functioning of the body's hormones, leading to the development of acanthosis nigricans Type 2.

The nasociliary branch of the ophthalmic division of the trigeminal nerve (V1) innervates the eye and tip of the nose. Hutchinson's sign is a clinical finding in which there is involvement of the nasociliary branch of V1 in herpes zoster infection. Therefore, a positive Hutchinson's sign in a patient with suspected zoster infection suggests herpes ophthalmicus, which is caused by the reactivation of the varicella-zoster virus in the ophthalmic division of the trigeminal nerve.

The sudden rash of bright, erythematous macules and acneiforms covering the patient's trunk and extremities suggests a drug eruption. One possible cause of this drug eruption is lithium, as it is known to cause skin reactions including acneiform eruptions. Additionally, the fact that the patient has recently undergone bypass surgery and has been hospitalized for the last 3 days suggests that he may have been prescribed lithium as a mood stabilizer. Therefore, lithium is the most likely medication that is causing the drug eruption in this case.