ROSH REVIEW Dermatology Questions and Answers | Latest Update | 2024/2025 | Already Passed

ROSH REVIEW Dermatology Questions and Answers | Latest Update | 2024/2025 | Already Passed 16-year-old girl is in the clinic because of bumps on her face. She noted these for the past couple of weeks that seem to worsen whenever she gets her period. On physical examination, there are multiple open and closed comedones on the nose and multiple erythematous papules and pustules on the nose and cheeks. Which of the following is the most likely diagnosis? Acne rosacea Acne vulgaris Perioral dermatitis Sebaceous hyperplasia Correct Answer ( B ) Explanation: The girl has examination findings consistent with acne vulgaris. Acne vulgaris is the most common cutaneous disorder affecting adolescents and young adults. It is a disease of pilosebaceous follicles. Four factors are involved: follicular hyperkeratinization, increased sebum production, Propionibacterium acnes within the follicle, and inflammation. The microcomedo is considered the precursor for the clinical lesions of acne vulgaris, including closed comedones, open comedones, and inflammatory papules, pustules, and nodules. Acne vulgaris typically affects those areas of the body that have the largest, hormonally responsive sebaceous glands, including the face, neck, chest, upper back, and upper arms. Young adolescents often have primarily comedonal acne consisting of noninflammatory lesions (closed or open comedones) involving the forehead, nose and chin. And as the acne progresses, patients develop inflammatory lesions (papules, pustules, and nodules). 24-year-old man presents for evaluation of a rash. The patient reports a mildly pruritic rash on his back and trunk that progressively spread over the last week. You examine and note the rash seen above. Which of the following historical elements is most likely to be obtained upon further questioning? A larger 2 to 5 cm erythematous patch preceded the diffuse rash Fever preceded the onset of rash Oral mucosal lesions preceded the onset of rash Travel to the Southeast USA occurred a week before the rash Correct Answer ( A ) Explanation: This patient has pityriasis rosea. This is a mild skin eruption that is self-limited usually lasting 4 to 7 weeks. There is no clear etiology of the rash although infection with Herpesvirus 7 or a fungus is suspected. Prior to the onset of the diffuse rash, patients may recall a herald patch described as a 2 to 5 cm erythematous oval plaque similar to the smaller more diffuse lesions. The rash is described as following a "Christmas tree" pattern on the trunk, classically following the skin cleavage lines. There is no indicated treatment for pityriasis rosea other than antihistamines for symptomatic relief if the rash is pruritic.