Derm ABIM Exam Study Guide.
Acne: Tx - Answer✔Mild: Topical retinoid + Benzoyl Peroxide
OR Topical Abx
Mod/severe/inflammatory: Systemic Abx, Oral Isotretinoin, OCPs
Acne in pregnancy, avoid? - Answer✔Isotretinoin
Rosacea sx, tx - Answer✔Sx: Symmetric central facial involvement, santa clause nose, diffuse
erthema
tx: Avoid triggers
- Topical flagyl, then oral abx then oral isotretinoin
Tx of hand dermatitis - Answer✔High potency corticosteroids
Seborrheic Dermatitis sx, dx, tx, associated - Answer✔Sx: Dry/Greasy yellow sharply
demarcated scales on erythmatous base localized to scalp, post auricular region, central face
tx; Shampoos (selenium/ketoconazole) for scalp. Antifungal creams +/- topical steroids for face
associations: Look for HIV, Parkinosons
Multipel seborrheic keratosis show up suddenly. Thoughts? - Answer✔Leser-Trelat sign. Think
internal malignancy
Actinic Keratosis sx, dx, tx - Answer✔Sx: Extensive UV exposure hx, erythematous, rough,
scaly papules
dx; Clinical, ?SCC concern get bx
tx: Cryotherapy if few lesions. Topical agensts (imiquimod) for many
Psoriasis sx, dx - Answer✔Sx: You know what it looks like
dx: PE w/ nail pitting, clinical findings. May consider ASO titer, RPR (Guttate)
Localized plaque type psoriasis sx, tx - Answer✔sx: Plaques w/ silvery white scales. Gluteal
pinking and umbhilcal skin involvement
tx: Topical high potency steroids, vitamin d, retinoids
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Guttate type psoriasis sx, tx - Answer✔Sx: Follws strep throat w/ numerous small, discrete
plaques that are widely distributed
tx: oral abx, observation
Inverse type psoriasis sx - Answer✔Shows up in axillae and groin (flexural surfaces)
Contraindicated in tx of psoriasis? - Answer✔Systemic Steroids
Impetigo sx, tx - Answer✔Sx: Vesicles/Pustules on the face w/ honey colored crust (staph or
strep)
tx: Mupirocin ointment if limited. PO Abx if more sefvere or if immunocompromised
ONychomycosis tx - Answer✔PO terbinafine, but recurrence is common
Pityriasis versicolor sx, dx, tx - Answer✔SX: Multiple areas of hypopigmentation
dx: Skin scraping w/ spaghetti and meatballs
tx; Is superficial - Topical Ketoconazole/Selenium shampoo. If not working, try fluconazole PO
Pearl to remember. If pt shows up with a tinea rash and it's painful? - Answer✔Superinfection w/
bacteria
Pityriasis Rosea sx, tx - Answer✔SX: Large hearld patch precede trunk eruption. Mild pruritis.
Salmon colored plaques. Christmas tree distrubution. Spares the face.
- consider syphillis as mimicker of this
tx: Self-Limited
HSV sx, dx, tx - Answer✔Sx: Small, grouped vesicles. Painful. Vermillion border on face,
genitals, buttocks
dx: Direct fluorescent ab, viral culture or PCR
tx: Acyclover immediate on outbreak. consider dailiy ppx if recurrent or severe. Alt option for
imm tx is foscarnet
Herpes Zoster sx, tx - Answer✔Sx: Acute itchy rash w/ vesicles at multiple stages (chickenpox).
Dermatomal pain followed by skin lesions (shingles)
tx: Acyclovir/Valacyclover if in first 72 hours. Vaccine. If complicated (eye, facial palsy) give
IV antivirals
Post-herpetic neuralgia tx - Answer✔Gabapentin, Pregabalin, TCA
Ramsay Hunt Syndrome sx, tx - Answer✔Bell palsy + Herpes Zoster
tx: Steroids and antiviral
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