Questions

Figure 1

► 1. A 70-year-old man presented with itching and flaking of his skin (Figure 1). Which of the following statements is NOT true?

1. The diagnosis is seborrheic dermatitis
2. The optimal treatment is a potent topical steroid
3. Associated systemic conditions to consider are Parkinson's disease and HIV/AIDS
4. Topical ketoconazole or ciclopirox are appropriate treatments for this condition

Figure 2

► 2. While examining your patient, you see this skin change on the patient's lower back (Figure 2). What symptoms do you expect her to describe?

1. Pruritus from urticaria
2. Pain from herpes zoster
3. Itching from allergy to clothing
4. Back pain

Figure 3

► 3. This young man's spots (Figure 3) itch and burn, last 2 to 3 days, and leave slight petechiae when fading. What is the most likely diagnosis?

1. Ordinary urticaria
2. Urticarial vasculitis
3. Dermographic urticaria
4. Large-vessel vasculitis

Figure 4

► 4. Which treatment would NOT be recommended for the condition shown in Figure 4?

1. Oral tetracycline HCl, 500-1000 mg/day
2. Topical metronidazole gel
3. Subantimicrobial dose of oral doxycycline, 20 mg twice daily, or 40 mg delayed release daily
4. Clobetasol propionate lotion

Figure 5

► 5. What are the most likely twin diagnoses for this patient (Figure 5)?

1. Osteoarthritis and eczema
2. Rheumatoid arthritis and eczema
3. Rheumatoid arthritis and rheumatoid nodules
4. Psoriasis and psoriatic arthritis

Figure 6

► 6. A 59-year-old woman who had received heart and lung transplants presents with a lesion on the forearm (Figure 6). She says that it first appeared 1 week ago, and it has been enlarging. One month earlier a dog had scratched her at this site. What is the most likely diagnosis?

1. Tinea corporis
2. Squamous-cell carcinoma of the skin
3. Graft-versus-host disease
4. Nummular dermatitis

Figure 7

► 7. What is the most likely diagnosis for the condition seen on the ear (Figure 7) of this 81-year-old man?

1. "Cauliflower ear" from old trauma
2. Chondrodermatitis nodularis helicis chronica
3. Basal-cell carcinoma
4. Actinic keratosis

Figure 8A

► 8. A 59-year-old man presented with a 1-week history of rash on his face, neck (Figure 8A), chest, and legs, along with a headache and myalgias. His wife is receiving chemotherapy for cancer. Which of the following statements is true?

1. Viral culture is the most rapid method to confirm the diagnosis
2. He does not require treatment with antiviral agents, because more than 3 days have passed since the onset of his rash
3. He will not develop postherpetic neuralgia, because he is younger than 60 years old
4. He should have a thorough evaluation for causes of immunosuppression

Figure 9A

► 9. A 73-year-old man presents with the new onset of a slowly enlarging brown spot on his forehead (Figure 9A). He is not eager to do anything about it, stating that his grandfather had a similar spot, and it "never gave him any trouble." The spot was not noted 2 years ago at his last examination. What would be the appropriate next step?

1. Immediate removal of the entire lesion with a 5-mm margin
2. Referral to a plastic surgeon for removal with a 5- to 10-mm margin and a sentinel node biopsy
3. Two or more 3-mm punch biopsies from various sites
4. Instruct him to use sunscreen, record the lesion measurement in his chart, and make a note to measure it again at his next check-up in 2 years

Figure 10

► 10. This child's eyelids (Figure 10) show the cutaneous sign of which disorder?

1. Dennie's pleats of atopic dermatitis
2. Heliotrope color of derma-tomyositis
3. Nits of pubic lice infestation
4. Bruising of child abuse