,USMLE Step 2 – Dermatology & Imaging |
2025 Clinical Q&A Bank with 230+ High-Yield
Questions for Rapid Review.
Basal Cell CA
-Shave Biopsy
-Mohs Micrographic Sx (especially for delicate areas of the face)
-^ UVB light exposure
Pale-skinned old lawn care worker with this lesion that started as a small erythematous spot a couple
years ago.
Squamous Cell CA
-Excisional Biopsy or Punch/Incisional Bx (if Excisional would be cosmetically harmful)
-Surgical Excision
-^ UVB light exposure
Older patient with history of immunosuppressive treatment.
Kaposi Sarcoma
-
-
1. Treat the AIDS! KS should disappear with ^CD4, if not..
2. Intralesional injections of Vincristine or Interferon
3. Liposomal Doxorubicin ChemoTx
-Caused by HHV8 (oncogenic virus) with concomitant AIDS (sexually transmitted AIDS strains, rarely
strains of IVDA!)
Often seen in old Mediterranean men
May find additional Kaposi tumors in GI tract and Lung
Mediterranean man with AIDS has this on his arm.
Actinic Keratosis
-R/o SCC with Bx
-Curretage, Cryotherapy, Laser, Topical 5-FU, or Topical Imiquimod (immunostimulant)
-Assoc'd with ^ UVB light exposure
"Premalignant"; A small % of the lesions become SCC, however b/c there are often many lesions in
one pt=>high risk of SCC.
A very old lifeguard with this on his cheek and a few more on his scalp and neck.
Seborrheic Keratoses
-
-Removed for cosmetic reasons via Cryotherapy, Laser, or Surgery.
-No malignant potential, HOWEVER a sudden eruption of SK is associated with GI adenocarcinomas.
, Old guy with a bunch of these:
Atopic Dermatitis aka Eczema
-Clinical Dx
-
1. Topical Corticosteroids for flares. Oral steroids for severe acute flares.
2. Topical Tacrolimus and Pimecrolimus (T Cell Inhibitors):
Long term control and to help wean steroid use. Rarely associated with developing Lymphoma.
3. Antihistamines:
Mild Dz- Nonsedating Rx (Cetirizine, Fexofenadine, Loratidine)
Severe Dz- Doxepine, Hydroxyzine, Diphenhydramine
4. UV Phototherapy: Severe recalcitrant Dz
5. ABx when superimposed Impetigo occurs:
Cephalexin, Mupirocin, Retapamulin
-Assoc'ns:
Asthma, Allergic Rhinitis, Fam Hx Atopy (allergies)
MCly onset before age 5.
Superimposed Impetigo (infection of GAS or S. aureus)
*1) Overactivity of Mast Cells and Elevated IgE
2) Stay moisturized (less itching), Use Humidifier, Avoid any irritants- hot
baths/soaps/washcloths/brushes/wool
3) FALSE, food allergies do not exacerbate eczema.*
Child with recurrent allergic rhinitis and asthmatic mother:
1) Pathophysiology?
2) Prevention?
3) True or False: Food allergies exacerbate this condition.
Psoriasis
-
-
Local Dz Tx-
1. Topical High Potency Steroids:
Fluocinonide, Triamcinolone, Betamethasone, Clobetasol. AE=Skin Atrophy (via Inhibition of Collagen
formation).
2. Vitamin A and Vitamin D (Calcipotriene) to help wean off steroids.
3. Coal tar preparation
4. Pimecrolimus and Tacrolimus for delicate areas (face, genitals) because less potential for atrophic
deformation.
Extensive Dz-
1. UV Phototherapy
2. Antitumor Necrosis Factor (TNF) Inhibitors:
Etanercept, Adalimumab, Infliximab; Highly efficacious but must screen for TB b/c will reactivate!!
3. Methotrexate:
Last resort b/c Liver and Lung AEs. Commonly used in Psoriatic Arthritis.
-
2025 Clinical Q&A Bank with 230+ High-Yield
Questions for Rapid Review.
Basal Cell CA
-Shave Biopsy
-Mohs Micrographic Sx (especially for delicate areas of the face)
-^ UVB light exposure
Pale-skinned old lawn care worker with this lesion that started as a small erythematous spot a couple
years ago.
Squamous Cell CA
-Excisional Biopsy or Punch/Incisional Bx (if Excisional would be cosmetically harmful)
-Surgical Excision
-^ UVB light exposure
Older patient with history of immunosuppressive treatment.
Kaposi Sarcoma
-
-
1. Treat the AIDS! KS should disappear with ^CD4, if not..
2. Intralesional injections of Vincristine or Interferon
3. Liposomal Doxorubicin ChemoTx
-Caused by HHV8 (oncogenic virus) with concomitant AIDS (sexually transmitted AIDS strains, rarely
strains of IVDA!)
Often seen in old Mediterranean men
May find additional Kaposi tumors in GI tract and Lung
Mediterranean man with AIDS has this on his arm.
Actinic Keratosis
-R/o SCC with Bx
-Curretage, Cryotherapy, Laser, Topical 5-FU, or Topical Imiquimod (immunostimulant)
-Assoc'd with ^ UVB light exposure
"Premalignant"; A small % of the lesions become SCC, however b/c there are often many lesions in
one pt=>high risk of SCC.
A very old lifeguard with this on his cheek and a few more on his scalp and neck.
Seborrheic Keratoses
-
-Removed for cosmetic reasons via Cryotherapy, Laser, or Surgery.
-No malignant potential, HOWEVER a sudden eruption of SK is associated with GI adenocarcinomas.
, Old guy with a bunch of these:
Atopic Dermatitis aka Eczema
-Clinical Dx
-
1. Topical Corticosteroids for flares. Oral steroids for severe acute flares.
2. Topical Tacrolimus and Pimecrolimus (T Cell Inhibitors):
Long term control and to help wean steroid use. Rarely associated with developing Lymphoma.
3. Antihistamines:
Mild Dz- Nonsedating Rx (Cetirizine, Fexofenadine, Loratidine)
Severe Dz- Doxepine, Hydroxyzine, Diphenhydramine
4. UV Phototherapy: Severe recalcitrant Dz
5. ABx when superimposed Impetigo occurs:
Cephalexin, Mupirocin, Retapamulin
-Assoc'ns:
Asthma, Allergic Rhinitis, Fam Hx Atopy (allergies)
MCly onset before age 5.
Superimposed Impetigo (infection of GAS or S. aureus)
*1) Overactivity of Mast Cells and Elevated IgE
2) Stay moisturized (less itching), Use Humidifier, Avoid any irritants- hot
baths/soaps/washcloths/brushes/wool
3) FALSE, food allergies do not exacerbate eczema.*
Child with recurrent allergic rhinitis and asthmatic mother:
1) Pathophysiology?
2) Prevention?
3) True or False: Food allergies exacerbate this condition.
Psoriasis
-
-
Local Dz Tx-
1. Topical High Potency Steroids:
Fluocinonide, Triamcinolone, Betamethasone, Clobetasol. AE=Skin Atrophy (via Inhibition of Collagen
formation).
2. Vitamin A and Vitamin D (Calcipotriene) to help wean off steroids.
3. Coal tar preparation
4. Pimecrolimus and Tacrolimus for delicate areas (face, genitals) because less potential for atrophic
deformation.
Extensive Dz-
1. UV Phototherapy
2. Antitumor Necrosis Factor (TNF) Inhibitors:
Etanercept, Adalimumab, Infliximab; Highly efficacious but must screen for TB b/c will reactivate!!
3. Methotrexate:
Last resort b/c Liver and Lung AEs. Commonly used in Psoriatic Arthritis.
-
