DERMATOLOGICAL CONDITIONS TEST
PAPER QUESTIONS AND SOLUTIONS
VERIFIED ANSWERS
●● Follicular hyperkertinization
Answer: Infundibulum (upper portion of hair follicle)
●● Increased sebum production
Answer: Excess oil production in the skin.
●● Propionibacterium acnes
Answer: Bacteria that converts lipids to fatty acids and produces pro-
inflammatory mediators.
●● Mild acne
Answer: Scattered comedones, small, <5mm, papules with no scarring,
limited skin involvement (one body area), no inflammatory nodules.
●● Moderate-severe acne
Answer: Many comedones or inflamed papules or pustules, multiple
body area involvement, presence of nodules, scarring is present.
,●● Papulopustule acne
Answer: Inflamed papules and pustules, typically <5mm.
●● Nodular/nodulocystic acne
Answer: Deep seated, inflamed, often tender, draining lesions or sinus
tracts may be present; true cysts are rare.
●● Clinical diagnosis of acne
Answer: Lab NOT required; comedones are required for a diagnosis of
any type of acne.
●● Mild/moderate acne treatment
Answer: Comedones ONLY- topical retinoids, OTC differin, NOT
recommended in pregnancy; papulopustules, +/- comedones- topical
retinoids AND benzoyl peroxide; adjuncts- topical antibiotics
(clindamycin).
●● Moderate/severe or refractory acne treatment
Answer: Tetracyclines, OCP, spironolactone for females; Accutane (oral
retinoid)- try before scarring, contraindicated in pregnancy (need 2
forms of birth control), monotherapy, need lab monitoring.
●● Follicular hyperproliferation treatment
Answer: Topical retinoids, oral isotretinoin, azelaic acid, salicylic acid.
,●● Increased sebum treatment
Answer: Oral isotretinoin, OCP, spironolactone.
●● Propionibacterium acnes treatment
Answer: Benzoyl peroxide, tetracyclines, topical retinoids, azelaic acid,
topical dapsone.
●● Perioral Dermatitis
Answer: Exact cause is not understood; suggested mechanism is
epidermal dysfunction that can be induced by topical steroids, cosmetics,
hormonal changes.
●● Features of Perioral Dermatitis
Answer: An acneiform eruption, erythematous base with sharp borders,
surrounding skin is often dry, scaly and flaky skin, burning or tightness,
itchy.
●● Clinical diagnosis of Perioral Dermatitis
Answer: Zero-therapy approach: advise patients to stop all topical
products, wash with gentle cleanser, wean any steroids.
●● Topical agents for Perioral Dermatitis
, Answer: Metronidazole 0.75%, Erythromycin 1%, Pimecrolimus 1% bid
for X4 weeks.
●● Rosacea
Answer: Possible causes include immune system dysfunction,
microorganisms (demodex mites), vascular hyperreactivity, UV light,
genetics.
●● Diagnostic phenotypes of Rosacea
Answer: Centrofacial erythema- chronic erythema of nose and medial
cheeks; phymatous changes- nose is most common, tissue hypertrophy
with irregular contours.
●● Major phenotypes of Rosacea
Answer: Papules and pustules, flushing, telangiectasia- visible enlarged
blood vessels, ocular features.
●● Secondary features of Rosacea
Answer: Burning, edema, dryness.
●● Clinical diagnosis of Rosacea
Answer: At least 1 diagnostic phenotype OR 2 major phenotypes.
●● General measures for Rosacea
PAPER QUESTIONS AND SOLUTIONS
VERIFIED ANSWERS
●● Follicular hyperkertinization
Answer: Infundibulum (upper portion of hair follicle)
●● Increased sebum production
Answer: Excess oil production in the skin.
●● Propionibacterium acnes
Answer: Bacteria that converts lipids to fatty acids and produces pro-
inflammatory mediators.
●● Mild acne
Answer: Scattered comedones, small, <5mm, papules with no scarring,
limited skin involvement (one body area), no inflammatory nodules.
●● Moderate-severe acne
Answer: Many comedones or inflamed papules or pustules, multiple
body area involvement, presence of nodules, scarring is present.
,●● Papulopustule acne
Answer: Inflamed papules and pustules, typically <5mm.
●● Nodular/nodulocystic acne
Answer: Deep seated, inflamed, often tender, draining lesions or sinus
tracts may be present; true cysts are rare.
●● Clinical diagnosis of acne
Answer: Lab NOT required; comedones are required for a diagnosis of
any type of acne.
●● Mild/moderate acne treatment
Answer: Comedones ONLY- topical retinoids, OTC differin, NOT
recommended in pregnancy; papulopustules, +/- comedones- topical
retinoids AND benzoyl peroxide; adjuncts- topical antibiotics
(clindamycin).
●● Moderate/severe or refractory acne treatment
Answer: Tetracyclines, OCP, spironolactone for females; Accutane (oral
retinoid)- try before scarring, contraindicated in pregnancy (need 2
forms of birth control), monotherapy, need lab monitoring.
●● Follicular hyperproliferation treatment
Answer: Topical retinoids, oral isotretinoin, azelaic acid, salicylic acid.
,●● Increased sebum treatment
Answer: Oral isotretinoin, OCP, spironolactone.
●● Propionibacterium acnes treatment
Answer: Benzoyl peroxide, tetracyclines, topical retinoids, azelaic acid,
topical dapsone.
●● Perioral Dermatitis
Answer: Exact cause is not understood; suggested mechanism is
epidermal dysfunction that can be induced by topical steroids, cosmetics,
hormonal changes.
●● Features of Perioral Dermatitis
Answer: An acneiform eruption, erythematous base with sharp borders,
surrounding skin is often dry, scaly and flaky skin, burning or tightness,
itchy.
●● Clinical diagnosis of Perioral Dermatitis
Answer: Zero-therapy approach: advise patients to stop all topical
products, wash with gentle cleanser, wean any steroids.
●● Topical agents for Perioral Dermatitis
, Answer: Metronidazole 0.75%, Erythromycin 1%, Pimecrolimus 1% bid
for X4 weeks.
●● Rosacea
Answer: Possible causes include immune system dysfunction,
microorganisms (demodex mites), vascular hyperreactivity, UV light,
genetics.
●● Diagnostic phenotypes of Rosacea
Answer: Centrofacial erythema- chronic erythema of nose and medial
cheeks; phymatous changes- nose is most common, tissue hypertrophy
with irregular contours.
●● Major phenotypes of Rosacea
Answer: Papules and pustules, flushing, telangiectasia- visible enlarged
blood vessels, ocular features.
●● Secondary features of Rosacea
Answer: Burning, edema, dryness.
●● Clinical diagnosis of Rosacea
Answer: At least 1 diagnostic phenotype OR 2 major phenotypes.
●● General measures for Rosacea
