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ROSH REVIEW Dermatology Practice Questions and Answers | 100% Pass

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ROSH REVIEW Dermatology Practice Questions and Answers | 100% Pass 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 h...

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  • September 15, 2024
  • 162
  • 2024/2025
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, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Tuesday, September 3, 2024 10:30 AM



ROSH REVIEW Dermatology Practice
Questions and Answers | 100% Pass


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 - Answer✔️✔️-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.

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, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Tuesday, September 3, 2024 10:30 AM




A history of travel to the Southeast USA (D) before the onset of rash should raise an

index of suspicion for an infectious etiology to the rash like Rocky Mountain Spotted

fever, a tick-borne illness caused by Rickettsia rickettsii. This illness occurs most

commonly in late spring and early summer and is characterized by a rash that starts

distally and spreads to the core.

One Step Further

Question: Is the rash of pityriasis rosea contagious? - Answer✔️✔️-Answer: No, the rash

cannot be spread by direct contact.

An 18-year-old obese woman presents to your office with a complaint of redness and

pain in her right axilla. Physical exam reveals a solitary nodule, approximately 2 cm in

size, with surrounding inflammation and erythema. She tells you that she's had similar

"boils" in the past. Which of the following is the most likely diagnosis?



Contact dermatitis

Dermoid cyst

Granuloma inguinale

Hidradenitis suppurativa - Answer✔️✔️-Correct Answer ( D )

Explanation:

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that causes

scarring, keloids, contractures and immobility. Originally believed to be caused by a

defect in the apocrine glands, it may also be due to a defect in the follicular epithelium.

HS begins in adolescence or adulthood in otherwise healthy individuals. Risk factors for


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, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Tuesday, September 3, 2024 10:30 AM


the development of HS include obesity, genetics, smoking, diet and mechanical stress

on the skin. Onset is insidious, with the first presentation generally being erythema in an

intertriginous skin area, most commonly the axilla. As the disease progresses, formation

of sinus tracts, multiple open comedomes and scarring occur. The initial presentation

can mimic other disorders and individuals often are diagnosed incorrectly with recurrent

furunculosis. Diagnosis is a clinical one. Treatment includes medical management in the

early stages and surgical intervention after the formation of abscesses or sinus tracts.

One Step Further

Question: What is the other name for hidradenitis suppurativa? - Answer✔️✔️-Answer:

Acne inversa.

A 60-year-old man with a history of diabetes presents to your office with a complaint of

thickened and discolored toenails. He tells you that his toenails have had this

appearance for over a year, and now he is experiencing discomfort when wearing tight-

fitting shoes. Physical exam reveals hyperkeratosis and onycholysis of bilateral great

and second toes. Which of the following is the most appropriate next step in

management?



Begin treatment with oral terbinafine

Check serum aminotransferases

Potassium hydroxide examination of toenail scrapings

Watchful waiting - Answer✔️✔️-Correct Answer ( C )

Explanation:




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