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Common Hair Disorders
Review the PDF of the fact sheet on common hair disorders with board-relevant, easy-to-review material. This fact sheet reviews information about the most common hair disorders, including clinical and histopathological features, trichoscopy, and management of these diseases.
Practice Questions
1. A 40-year-old woman presents to the clinic with a burning sensation and tenderness on the scalp. At physical examination you notice erythematous papules and pustules on the vertex scalp. The most likely diagnosis is:
a. alopecia areata
b. CCSA
c. folliculitis decalvans
d. lichen planopilaris
e. traction alopecia
2. A 60-year-old woman presents with receding hair loss on the frontal and bitemporal scalp. She has noticed hair loss on her eyebrows. She has a history of oral ulcers. On physical examination there is mild erythema and perifollicular scales on the frontal hairline. A hair pull test is positive in this area. The most likely diagnosis is:
a. androgenetic alopecia
b. chronic cutaneous lupus erythematosus
c. frontal fibrosing alopecia
d. telogen effluvium
e. trichotillomania
3. A 5-year-old girl with a history of seasonal allergies and eczema presents with recurrent patchy hair loss on the scalp of 6 months’ duration. Her mother has noticed rapidly progressive hair loss affecting the whole scalp. On trichoscopy, you find yellow dots, broken hairs, and tapering hairs. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. telogen effluvium
d. traction alopecia
e. trichotillomania
4. A 30-year-old white woman with history of obsessive-compulsive disorder presents to the clinic with hair loss for the last 3 years. She says she has noticed worsening of the hair loss when she is under stress. She also bites her nails. On physical examination you identify an irregular patch of alopecia with broken hairs on the occipital scalp. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. lichen planopilaris
d. traction alopecia
e. trichotillomania
5. A 45-year-old black woman who has a family history of hair loss in her mother presents with tenderness and burning sensation on the vertex scalp. She reports the hair loss was worse after she got a hair relaxer 6 months prior. She uses braids on her scalp and she has not had a relaxer since then. The most likely diagnosis is:
a. CCSA
b. chronic cutaneous lupus erythematosus
c. folliculitis decalvans
d. lichen planopilaris
e. trichotillomania
Answers to practice questions provided on next page
Practice Question Answers
1. A 40-year-old woman presents to the clinic with a burning sensation and tenderness on the scalp. At physical examination you notice erythematous papules and pustules on the vertex scalp. The most likely diagnosis is:
a. alopecia areata
b. CCSA
c. folliculitis decalvans
d. lichen planopilaris
e. traction alopecia
2. A 60-year-old woman presents with receding hair loss on the frontal and bitemporal scalp. She has noticed hair loss on her eyebrows. She has a history of oral ulcers. On physical examination there is mild erythema and perifollicular scales on the frontal hairline. A hair pull test is positive in this area. The most likely diagnosis is:
a. androgenetic alopecia
b. chronic cutaneous lupus erythematosus
c. frontal fibrosing alopecia
d. telogen effluvium
e. trichotillomania
3. A 5-year-old girl with a history of seasonal allergies and eczema presents with recurrent patchy hair loss on the scalp of 6 months’ duration. Her mother has noticed rapidly progressive hair loss affecting the whole scalp. On trichoscopy, you find yellow dots, broken hairs, and tapering hairs. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. telogen effluvium
d. traction alopecia
e. trichotillomania
4. A 30-year-old white woman with history of obsessive-compulsive disorder presents to the clinic with hair loss for the last 3 years. She says she has noticed worsening of the hair loss when she is under stress. She also bites her nails. On physical examination you identify an irregular patch of alopecia with broken hairs on the occipital scalp. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. lichen planopilaris
d. traction alopecia
e. trichotillomania
5. A 45-year-old black woman who has a family history of hair loss in her mother presents with tenderness and burning sensation on the vertex scalp. She reports the hair loss was worse after she got a hair relaxer 6 months prior. She uses braids on her scalp and she has not had a relaxer since then. The most likely diagnosis is:
a. CCSA
b. chronic cutaneous lupus erythematosus
c. folliculitis decalvans
d. lichen planopilaris
e. trichotillomania
Review the PDF of the fact sheet on common hair disorders with board-relevant, easy-to-review material. This fact sheet reviews information about the most common hair disorders, including clinical and histopathological features, trichoscopy, and management of these diseases.
Practice Questions
1. A 40-year-old woman presents to the clinic with a burning sensation and tenderness on the scalp. At physical examination you notice erythematous papules and pustules on the vertex scalp. The most likely diagnosis is:
a. alopecia areata
b. CCSA
c. folliculitis decalvans
d. lichen planopilaris
e. traction alopecia
2. A 60-year-old woman presents with receding hair loss on the frontal and bitemporal scalp. She has noticed hair loss on her eyebrows. She has a history of oral ulcers. On physical examination there is mild erythema and perifollicular scales on the frontal hairline. A hair pull test is positive in this area. The most likely diagnosis is:
a. androgenetic alopecia
b. chronic cutaneous lupus erythematosus
c. frontal fibrosing alopecia
d. telogen effluvium
e. trichotillomania
3. A 5-year-old girl with a history of seasonal allergies and eczema presents with recurrent patchy hair loss on the scalp of 6 months’ duration. Her mother has noticed rapidly progressive hair loss affecting the whole scalp. On trichoscopy, you find yellow dots, broken hairs, and tapering hairs. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. telogen effluvium
d. traction alopecia
e. trichotillomania
4. A 30-year-old white woman with history of obsessive-compulsive disorder presents to the clinic with hair loss for the last 3 years. She says she has noticed worsening of the hair loss when she is under stress. She also bites her nails. On physical examination you identify an irregular patch of alopecia with broken hairs on the occipital scalp. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. lichen planopilaris
d. traction alopecia
e. trichotillomania
5. A 45-year-old black woman who has a family history of hair loss in her mother presents with tenderness and burning sensation on the vertex scalp. She reports the hair loss was worse after she got a hair relaxer 6 months prior. She uses braids on her scalp and she has not had a relaxer since then. The most likely diagnosis is:
a. CCSA
b. chronic cutaneous lupus erythematosus
c. folliculitis decalvans
d. lichen planopilaris
e. trichotillomania
Answers to practice questions provided on next page
Practice Question Answers
1. A 40-year-old woman presents to the clinic with a burning sensation and tenderness on the scalp. At physical examination you notice erythematous papules and pustules on the vertex scalp. The most likely diagnosis is:
a. alopecia areata
b. CCSA
c. folliculitis decalvans
d. lichen planopilaris
e. traction alopecia
2. A 60-year-old woman presents with receding hair loss on the frontal and bitemporal scalp. She has noticed hair loss on her eyebrows. She has a history of oral ulcers. On physical examination there is mild erythema and perifollicular scales on the frontal hairline. A hair pull test is positive in this area. The most likely diagnosis is:
a. androgenetic alopecia
b. chronic cutaneous lupus erythematosus
c. frontal fibrosing alopecia
d. telogen effluvium
e. trichotillomania
3. A 5-year-old girl with a history of seasonal allergies and eczema presents with recurrent patchy hair loss on the scalp of 6 months’ duration. Her mother has noticed rapidly progressive hair loss affecting the whole scalp. On trichoscopy, you find yellow dots, broken hairs, and tapering hairs. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. telogen effluvium
d. traction alopecia
e. trichotillomania
4. A 30-year-old white woman with history of obsessive-compulsive disorder presents to the clinic with hair loss for the last 3 years. She says she has noticed worsening of the hair loss when she is under stress. She also bites her nails. On physical examination you identify an irregular patch of alopecia with broken hairs on the occipital scalp. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. lichen planopilaris
d. traction alopecia
e. trichotillomania
5. A 45-year-old black woman who has a family history of hair loss in her mother presents with tenderness and burning sensation on the vertex scalp. She reports the hair loss was worse after she got a hair relaxer 6 months prior. She uses braids on her scalp and she has not had a relaxer since then. The most likely diagnosis is:
a. CCSA
b. chronic cutaneous lupus erythematosus
c. folliculitis decalvans
d. lichen planopilaris
e. trichotillomania
Review the PDF of the fact sheet on common hair disorders with board-relevant, easy-to-review material. This fact sheet reviews information about the most common hair disorders, including clinical and histopathological features, trichoscopy, and management of these diseases.
Practice Questions
1. A 40-year-old woman presents to the clinic with a burning sensation and tenderness on the scalp. At physical examination you notice erythematous papules and pustules on the vertex scalp. The most likely diagnosis is:
a. alopecia areata
b. CCSA
c. folliculitis decalvans
d. lichen planopilaris
e. traction alopecia
2. A 60-year-old woman presents with receding hair loss on the frontal and bitemporal scalp. She has noticed hair loss on her eyebrows. She has a history of oral ulcers. On physical examination there is mild erythema and perifollicular scales on the frontal hairline. A hair pull test is positive in this area. The most likely diagnosis is:
a. androgenetic alopecia
b. chronic cutaneous lupus erythematosus
c. frontal fibrosing alopecia
d. telogen effluvium
e. trichotillomania
3. A 5-year-old girl with a history of seasonal allergies and eczema presents with recurrent patchy hair loss on the scalp of 6 months’ duration. Her mother has noticed rapidly progressive hair loss affecting the whole scalp. On trichoscopy, you find yellow dots, broken hairs, and tapering hairs. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. telogen effluvium
d. traction alopecia
e. trichotillomania
4. A 30-year-old white woman with history of obsessive-compulsive disorder presents to the clinic with hair loss for the last 3 years. She says she has noticed worsening of the hair loss when she is under stress. She also bites her nails. On physical examination you identify an irregular patch of alopecia with broken hairs on the occipital scalp. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. lichen planopilaris
d. traction alopecia
e. trichotillomania
5. A 45-year-old black woman who has a family history of hair loss in her mother presents with tenderness and burning sensation on the vertex scalp. She reports the hair loss was worse after she got a hair relaxer 6 months prior. She uses braids on her scalp and she has not had a relaxer since then. The most likely diagnosis is:
a. CCSA
b. chronic cutaneous lupus erythematosus
c. folliculitis decalvans
d. lichen planopilaris
e. trichotillomania
Answers to practice questions provided on next page
Practice Question Answers
1. A 40-year-old woman presents to the clinic with a burning sensation and tenderness on the scalp. At physical examination you notice erythematous papules and pustules on the vertex scalp. The most likely diagnosis is:
a. alopecia areata
b. CCSA
c. folliculitis decalvans
d. lichen planopilaris
e. traction alopecia
2. A 60-year-old woman presents with receding hair loss on the frontal and bitemporal scalp. She has noticed hair loss on her eyebrows. She has a history of oral ulcers. On physical examination there is mild erythema and perifollicular scales on the frontal hairline. A hair pull test is positive in this area. The most likely diagnosis is:
a. androgenetic alopecia
b. chronic cutaneous lupus erythematosus
c. frontal fibrosing alopecia
d. telogen effluvium
e. trichotillomania
3. A 5-year-old girl with a history of seasonal allergies and eczema presents with recurrent patchy hair loss on the scalp of 6 months’ duration. Her mother has noticed rapidly progressive hair loss affecting the whole scalp. On trichoscopy, you find yellow dots, broken hairs, and tapering hairs. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. telogen effluvium
d. traction alopecia
e. trichotillomania
4. A 30-year-old white woman with history of obsessive-compulsive disorder presents to the clinic with hair loss for the last 3 years. She says she has noticed worsening of the hair loss when she is under stress. She also bites her nails. On physical examination you identify an irregular patch of alopecia with broken hairs on the occipital scalp. The most likely diagnosis is:
a. alopecia areata
b. androgenetic alopecia
c. lichen planopilaris
d. traction alopecia
e. trichotillomania
5. A 45-year-old black woman who has a family history of hair loss in her mother presents with tenderness and burning sensation on the vertex scalp. She reports the hair loss was worse after she got a hair relaxer 6 months prior. She uses braids on her scalp and she has not had a relaxer since then. The most likely diagnosis is:
a. CCSA
b. chronic cutaneous lupus erythematosus
c. folliculitis decalvans
d. lichen planopilaris
e. trichotillomania
Sexually Transmitted Diseases
Review the PDF of the fact sheet on sexually transmitted diseases with board-relevant, easy-to-review material. This month's fact sheet offers a comprehensive review of the etiology, clinical findings, and management of common STDs.
Practice Questions
1. A 44-year-old woman presents with fever, lymphadenopathy, and headaches. She has noticed a rash on her palms and soles that is not itchy. What is the diagnosis?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. secondary syphilis
2. A 37-year-old man presents with dysuria and purulent discharge. What is the appropriate test for diagnosis?
a. dark field microscopy
b. Giemsa staining
c. McCoy culture
d. porphyrin test (hemin [X factor]) culture
e. Thayer-Martin medium
3. Which disease in the neonate is preventable with silver nitrate drops?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. syphilis
4. A 22-year-old pregnant woman develops a painless indurated ulcer on the vagina. What is the treatment of choice?
a. azithromycin
b. ceftriaxone
c. doxycycline
d. penicillin G
e. TMP-SMX
5. What sexually transmitted disease facilitates the transmission of HIV?
a. chancroid
b. gonorrhea
c. lymphogranuloma venereum
d. syphilis
e. all of the above
Answers to practice questions provided on next page
Practice Question Answers
1. A 44-year-old woman presents with fever, lymphadenopathy, and headaches. She has noticed a rash on her palms and soles that is not itchy. What is the diagnosis?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. secondary syphilis
2. A 37-year-old man presents with dysuria and purulent discharge. What is the appropriate test for diagnosis?
a. dark field microscopy
b. Giemsa staining
c. McCoy culture
d. porphyrin test (hemin [X factor]) culture
e. Thayer-Martin medium
3. Which disease in the neonate is preventable with silver nitrate drops?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. syphilis
4. A 22-year-old pregnant woman develops a painless indurated ulcer on the vagina. What is the treatment of choice?
a. azithromycin
b. ceftriaxone
c. doxycycline
d. penicillin G
e. TMP-SMX
5. What sexually transmitted disease facilitates the transmission of HIV?
a. chancroid
b. gonorrhea
c. lymphogranuloma venereum
d. syphilis
e. all of the above
Review the PDF of the fact sheet on sexually transmitted diseases with board-relevant, easy-to-review material. This month's fact sheet offers a comprehensive review of the etiology, clinical findings, and management of common STDs.
Practice Questions
1. A 44-year-old woman presents with fever, lymphadenopathy, and headaches. She has noticed a rash on her palms and soles that is not itchy. What is the diagnosis?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. secondary syphilis
2. A 37-year-old man presents with dysuria and purulent discharge. What is the appropriate test for diagnosis?
a. dark field microscopy
b. Giemsa staining
c. McCoy culture
d. porphyrin test (hemin [X factor]) culture
e. Thayer-Martin medium
3. Which disease in the neonate is preventable with silver nitrate drops?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. syphilis
4. A 22-year-old pregnant woman develops a painless indurated ulcer on the vagina. What is the treatment of choice?
a. azithromycin
b. ceftriaxone
c. doxycycline
d. penicillin G
e. TMP-SMX
5. What sexually transmitted disease facilitates the transmission of HIV?
a. chancroid
b. gonorrhea
c. lymphogranuloma venereum
d. syphilis
e. all of the above
Answers to practice questions provided on next page
Practice Question Answers
1. A 44-year-old woman presents with fever, lymphadenopathy, and headaches. She has noticed a rash on her palms and soles that is not itchy. What is the diagnosis?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. secondary syphilis
2. A 37-year-old man presents with dysuria and purulent discharge. What is the appropriate test for diagnosis?
a. dark field microscopy
b. Giemsa staining
c. McCoy culture
d. porphyrin test (hemin [X factor]) culture
e. Thayer-Martin medium
3. Which disease in the neonate is preventable with silver nitrate drops?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. syphilis
4. A 22-year-old pregnant woman develops a painless indurated ulcer on the vagina. What is the treatment of choice?
a. azithromycin
b. ceftriaxone
c. doxycycline
d. penicillin G
e. TMP-SMX
5. What sexually transmitted disease facilitates the transmission of HIV?
a. chancroid
b. gonorrhea
c. lymphogranuloma venereum
d. syphilis
e. all of the above
Review the PDF of the fact sheet on sexually transmitted diseases with board-relevant, easy-to-review material. This month's fact sheet offers a comprehensive review of the etiology, clinical findings, and management of common STDs.
Practice Questions
1. A 44-year-old woman presents with fever, lymphadenopathy, and headaches. She has noticed a rash on her palms and soles that is not itchy. What is the diagnosis?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. secondary syphilis
2. A 37-year-old man presents with dysuria and purulent discharge. What is the appropriate test for diagnosis?
a. dark field microscopy
b. Giemsa staining
c. McCoy culture
d. porphyrin test (hemin [X factor]) culture
e. Thayer-Martin medium
3. Which disease in the neonate is preventable with silver nitrate drops?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. syphilis
4. A 22-year-old pregnant woman develops a painless indurated ulcer on the vagina. What is the treatment of choice?
a. azithromycin
b. ceftriaxone
c. doxycycline
d. penicillin G
e. TMP-SMX
5. What sexually transmitted disease facilitates the transmission of HIV?
a. chancroid
b. gonorrhea
c. lymphogranuloma venereum
d. syphilis
e. all of the above
Answers to practice questions provided on next page
Practice Question Answers
1. A 44-year-old woman presents with fever, lymphadenopathy, and headaches. She has noticed a rash on her palms and soles that is not itchy. What is the diagnosis?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. secondary syphilis
2. A 37-year-old man presents with dysuria and purulent discharge. What is the appropriate test for diagnosis?
a. dark field microscopy
b. Giemsa staining
c. McCoy culture
d. porphyrin test (hemin [X factor]) culture
e. Thayer-Martin medium
3. Which disease in the neonate is preventable with silver nitrate drops?
a. chancroid
b. gonorrhea
c. granuloma inguinale
d. lymphogranuloma venereum
e. syphilis
4. A 22-year-old pregnant woman develops a painless indurated ulcer on the vagina. What is the treatment of choice?
a. azithromycin
b. ceftriaxone
c. doxycycline
d. penicillin G
e. TMP-SMX
5. What sexually transmitted disease facilitates the transmission of HIV?
a. chancroid
b. gonorrhea
c. lymphogranuloma venereum
d. syphilis
e. all of the above
Vulvar Diseases, Part 2
After, test your knowledge by answering the 5 practice questions.
Practice Questions
1. A 5-year-old girl presented to your clinic with an itchy rash in the vulvar and anal regions. The patient’s mother reported erythema and erosion of the anal area. Her pediatrician prescribed an oral antibiotic that showed good results but the condition recurred 2 weeks after she finished the medication. The most likely diagnosis is:
a. Behçet disease
b. pemphigus vulgaris
c. perianal streptococcal dermatitis
d. plasma cell vulvitis
e. vulvodynia
2. A 34-year-old woman presented with pain and a burning sensation on the vulva. She reported a history of migraines. On physical examination, mild erythema was noted on the labia majora and minora and the patient reported pain to the touch of a cotton-tipped applicator in the vestibule. The most likely diagnosis is:
a. Crohn disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
3. A 25-year-old woman with a history of oral ulcers presented to your clinic with pain in the genital area. On physical examination, multiple ulcers were noted on the labia majora with no discharge. The most likely diagnosis is:
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
4. A 56-year-old woman presented to your clinic with vulvar pruritus and a burning sensation of 6 months’ duration. She had used a topical antibiotic and hydrocortisone cream 1% without relief. On physical examination, a red, irregular plaque is noted on the vestibule. The most likely diagnosis is:
a. Behçet disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
5. A 44-year-old woman presented to your clinic with pain and edema of the vulva. At physical examination, erythema and fissures were noted around the anus with fistulas involving the perianal skin. What is the most likely diagnosis?
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
1. A 5-year-old girl presented to your clinic with an itchy rash in the vulvar and anal regions. The patient’s mother reported erythema and erosion of the anal area. Her pediatrician prescribed an oral antibiotic that showed good results but the condition recurred 2 weeks after she finished the medication. The most likely diagnosis is:
a. Behçet disease
b. pemphigus vulgaris
c. perianal streptococcal dermatitis
d. plasma cell vulvitis
e. vulvodynia
2. A 34-year-old woman presented with pain and a burning sensation on the vulva. She reported a history of migraines. On physical examination, mild erythema was noted on the labia majora and minora and the patient reported pain to the touch of a cotton-tipped applicator in the vestibule. The most likely diagnosis is:
a. Crohn disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
3. A 25-year-old woman with a history of oral ulcers presented to your clinic with pain in the genital area. On physical examination, multiple ulcers were noted on the labia majora with no discharge. The most likely diagnosis is:
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
4. A 56-year-old woman presented to your clinic with vulvar pruritus and a burning sensation of 6 months’ duration. She had used a topical antibiotic and hydrocortisone cream 1% without relief. On physical examination, a red, irregular plaque is noted on the vestibule. The most likely diagnosis is:
a. Behçet disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
5. A 44-year-old woman presented to your clinic with pain and edema of the vulva. At physical examination, erythema and fissures were noted around the anus with fistulas involving the perianal skin. What is the most likely diagnosis?
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
After, test your knowledge by answering the 5 practice questions.
Practice Questions
1. A 5-year-old girl presented to your clinic with an itchy rash in the vulvar and anal regions. The patient’s mother reported erythema and erosion of the anal area. Her pediatrician prescribed an oral antibiotic that showed good results but the condition recurred 2 weeks after she finished the medication. The most likely diagnosis is:
a. Behçet disease
b. pemphigus vulgaris
c. perianal streptococcal dermatitis
d. plasma cell vulvitis
e. vulvodynia
2. A 34-year-old woman presented with pain and a burning sensation on the vulva. She reported a history of migraines. On physical examination, mild erythema was noted on the labia majora and minora and the patient reported pain to the touch of a cotton-tipped applicator in the vestibule. The most likely diagnosis is:
a. Crohn disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
3. A 25-year-old woman with a history of oral ulcers presented to your clinic with pain in the genital area. On physical examination, multiple ulcers were noted on the labia majora with no discharge. The most likely diagnosis is:
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
4. A 56-year-old woman presented to your clinic with vulvar pruritus and a burning sensation of 6 months’ duration. She had used a topical antibiotic and hydrocortisone cream 1% without relief. On physical examination, a red, irregular plaque is noted on the vestibule. The most likely diagnosis is:
a. Behçet disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
5. A 44-year-old woman presented to your clinic with pain and edema of the vulva. At physical examination, erythema and fissures were noted around the anus with fistulas involving the perianal skin. What is the most likely diagnosis?
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
1. A 5-year-old girl presented to your clinic with an itchy rash in the vulvar and anal regions. The patient’s mother reported erythema and erosion of the anal area. Her pediatrician prescribed an oral antibiotic that showed good results but the condition recurred 2 weeks after she finished the medication. The most likely diagnosis is:
a. Behçet disease
b. pemphigus vulgaris
c. perianal streptococcal dermatitis
d. plasma cell vulvitis
e. vulvodynia
2. A 34-year-old woman presented with pain and a burning sensation on the vulva. She reported a history of migraines. On physical examination, mild erythema was noted on the labia majora and minora and the patient reported pain to the touch of a cotton-tipped applicator in the vestibule. The most likely diagnosis is:
a. Crohn disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
3. A 25-year-old woman with a history of oral ulcers presented to your clinic with pain in the genital area. On physical examination, multiple ulcers were noted on the labia majora with no discharge. The most likely diagnosis is:
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
4. A 56-year-old woman presented to your clinic with vulvar pruritus and a burning sensation of 6 months’ duration. She had used a topical antibiotic and hydrocortisone cream 1% without relief. On physical examination, a red, irregular plaque is noted on the vestibule. The most likely diagnosis is:
a. Behçet disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
5. A 44-year-old woman presented to your clinic with pain and edema of the vulva. At physical examination, erythema and fissures were noted around the anus with fistulas involving the perianal skin. What is the most likely diagnosis?
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
After, test your knowledge by answering the 5 practice questions.
Practice Questions
1. A 5-year-old girl presented to your clinic with an itchy rash in the vulvar and anal regions. The patient’s mother reported erythema and erosion of the anal area. Her pediatrician prescribed an oral antibiotic that showed good results but the condition recurred 2 weeks after she finished the medication. The most likely diagnosis is:
a. Behçet disease
b. pemphigus vulgaris
c. perianal streptococcal dermatitis
d. plasma cell vulvitis
e. vulvodynia
2. A 34-year-old woman presented with pain and a burning sensation on the vulva. She reported a history of migraines. On physical examination, mild erythema was noted on the labia majora and minora and the patient reported pain to the touch of a cotton-tipped applicator in the vestibule. The most likely diagnosis is:
a. Crohn disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
3. A 25-year-old woman with a history of oral ulcers presented to your clinic with pain in the genital area. On physical examination, multiple ulcers were noted on the labia majora with no discharge. The most likely diagnosis is:
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
4. A 56-year-old woman presented to your clinic with vulvar pruritus and a burning sensation of 6 months’ duration. She had used a topical antibiotic and hydrocortisone cream 1% without relief. On physical examination, a red, irregular plaque is noted on the vestibule. The most likely diagnosis is:
a. Behçet disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
5. A 44-year-old woman presented to your clinic with pain and edema of the vulva. At physical examination, erythema and fissures were noted around the anus with fistulas involving the perianal skin. What is the most likely diagnosis?
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
1. A 5-year-old girl presented to your clinic with an itchy rash in the vulvar and anal regions. The patient’s mother reported erythema and erosion of the anal area. Her pediatrician prescribed an oral antibiotic that showed good results but the condition recurred 2 weeks after she finished the medication. The most likely diagnosis is:
a. Behçet disease
b. pemphigus vulgaris
c. perianal streptococcal dermatitis
d. plasma cell vulvitis
e. vulvodynia
2. A 34-year-old woman presented with pain and a burning sensation on the vulva. She reported a history of migraines. On physical examination, mild erythema was noted on the labia majora and minora and the patient reported pain to the touch of a cotton-tipped applicator in the vestibule. The most likely diagnosis is:
a. Crohn disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
3. A 25-year-old woman with a history of oral ulcers presented to your clinic with pain in the genital area. On physical examination, multiple ulcers were noted on the labia majora with no discharge. The most likely diagnosis is:
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
4. A 56-year-old woman presented to your clinic with vulvar pruritus and a burning sensation of 6 months’ duration. She had used a topical antibiotic and hydrocortisone cream 1% without relief. On physical examination, a red, irregular plaque is noted on the vestibule. The most likely diagnosis is:
a. Behçet disease
b. extramammary Paget disease
c. pemphigus vulgaris
d. plasma cell vulvitis
e. vulvodynia
5. A 44-year-old woman presented to your clinic with pain and edema of the vulva. At physical examination, erythema and fissures were noted around the anus with fistulas involving the perianal skin. What is the most likely diagnosis?
a. Behçet disease
b. Crohn disease
c. extramammary Paget disease
d. pemphigus vulgaris
e. plasma cell vulvitis
Dermatoses of Pregnancy
After, test your knowledge by answering the 5 practice questions.
Practice Questions
1. Which dermatosis of pregnancy occurs during the third trimester and is associated with multiple gestation pregnancies?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. intrahepatic cholestasis of pregnancy
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
2. Which dermatosis of pregnancy frequently flares after delivery?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. polymorphic eruption of pregnancy
d. prurigo gravidarum
e. prurigo of pregnancy
3. Which dermatosis of pregnancy has lesions that have a predilection for the abdominal striae?
a. cholestasis of pregnancy
b. gestational pemphigoid
c. prurigo gestationis
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
4. Which dermatosis of pregnancy has a risk for the development of hydatidiform moles and choriocarcinomas?
a. atopic eruption of pregnancy
b. cholestasis of pregnancy
c. gestational pemphigoid
d. pruritic urticarial papules and plaques of pregnancy
e. toxic erythema of pregnancy
5. Intrahepatic cholestasis of pregnancy has been associated with:
a. fetal mortality as high as 13%
b. jaundice in 20% of cases
c. onset in the third trimester of pregnancy
d. recurrence in subsequent pregnancies
e. all of the above
The answers appear on the next page.
1. Which dermatosis of pregnancy occurs during the third trimester and is associated with multiple gestation pregnancies?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. intrahepatic cholestasis of pregnancy
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
2. Which dermatosis of pregnancy frequently flares after delivery?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. polymorphic eruption of pregnancy
d. prurigo gravidarum
e. prurigo of pregnancy
3. Which dermatosis of pregnancy has lesions that have a predilection for the abdominal striae?
a. cholestasis of pregnancy
b. gestational pemphigoid
c. prurigo gestationis
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
4. Which dermatosis of pregnancy has a risk for the development of hydatidiform moles and choriocarcinomas?
a. atopic eruption of pregnancy
b. cholestasis of pregnancy
c. gestational pemphigoid
d. pruritic urticarial papules and plaques of pregnancy
e. toxic erythema of pregnancy
5. Intrahepatic cholestasis of pregnancy has been associated with:
a. fetal mortality as high as 13%
b. jaundice in 20% of cases
c. onset in the third trimester of pregnancy
d. recurrence in subsequent pregnancies
e. all of the above
After, test your knowledge by answering the 5 practice questions.
Practice Questions
1. Which dermatosis of pregnancy occurs during the third trimester and is associated with multiple gestation pregnancies?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. intrahepatic cholestasis of pregnancy
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
2. Which dermatosis of pregnancy frequently flares after delivery?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. polymorphic eruption of pregnancy
d. prurigo gravidarum
e. prurigo of pregnancy
3. Which dermatosis of pregnancy has lesions that have a predilection for the abdominal striae?
a. cholestasis of pregnancy
b. gestational pemphigoid
c. prurigo gestationis
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
4. Which dermatosis of pregnancy has a risk for the development of hydatidiform moles and choriocarcinomas?
a. atopic eruption of pregnancy
b. cholestasis of pregnancy
c. gestational pemphigoid
d. pruritic urticarial papules and plaques of pregnancy
e. toxic erythema of pregnancy
5. Intrahepatic cholestasis of pregnancy has been associated with:
a. fetal mortality as high as 13%
b. jaundice in 20% of cases
c. onset in the third trimester of pregnancy
d. recurrence in subsequent pregnancies
e. all of the above
The answers appear on the next page.
1. Which dermatosis of pregnancy occurs during the third trimester and is associated with multiple gestation pregnancies?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. intrahepatic cholestasis of pregnancy
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
2. Which dermatosis of pregnancy frequently flares after delivery?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. polymorphic eruption of pregnancy
d. prurigo gravidarum
e. prurigo of pregnancy
3. Which dermatosis of pregnancy has lesions that have a predilection for the abdominal striae?
a. cholestasis of pregnancy
b. gestational pemphigoid
c. prurigo gestationis
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
4. Which dermatosis of pregnancy has a risk for the development of hydatidiform moles and choriocarcinomas?
a. atopic eruption of pregnancy
b. cholestasis of pregnancy
c. gestational pemphigoid
d. pruritic urticarial papules and plaques of pregnancy
e. toxic erythema of pregnancy
5. Intrahepatic cholestasis of pregnancy has been associated with:
a. fetal mortality as high as 13%
b. jaundice in 20% of cases
c. onset in the third trimester of pregnancy
d. recurrence in subsequent pregnancies
e. all of the above
After, test your knowledge by answering the 5 practice questions.
Practice Questions
1. Which dermatosis of pregnancy occurs during the third trimester and is associated with multiple gestation pregnancies?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. intrahepatic cholestasis of pregnancy
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
2. Which dermatosis of pregnancy frequently flares after delivery?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. polymorphic eruption of pregnancy
d. prurigo gravidarum
e. prurigo of pregnancy
3. Which dermatosis of pregnancy has lesions that have a predilection for the abdominal striae?
a. cholestasis of pregnancy
b. gestational pemphigoid
c. prurigo gestationis
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
4. Which dermatosis of pregnancy has a risk for the development of hydatidiform moles and choriocarcinomas?
a. atopic eruption of pregnancy
b. cholestasis of pregnancy
c. gestational pemphigoid
d. pruritic urticarial papules and plaques of pregnancy
e. toxic erythema of pregnancy
5. Intrahepatic cholestasis of pregnancy has been associated with:
a. fetal mortality as high as 13%
b. jaundice in 20% of cases
c. onset in the third trimester of pregnancy
d. recurrence in subsequent pregnancies
e. all of the above
The answers appear on the next page.
1. Which dermatosis of pregnancy occurs during the third trimester and is associated with multiple gestation pregnancies?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. intrahepatic cholestasis of pregnancy
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
2. Which dermatosis of pregnancy frequently flares after delivery?
a. atopic eruption of pregnancy
b. gestational pemphigoid
c. polymorphic eruption of pregnancy
d. prurigo gravidarum
e. prurigo of pregnancy
3. Which dermatosis of pregnancy has lesions that have a predilection for the abdominal striae?
a. cholestasis of pregnancy
b. gestational pemphigoid
c. prurigo gestationis
d. prurigo of pregnancy
e. pruritic urticarial papules and plaques of pregnancy
4. Which dermatosis of pregnancy has a risk for the development of hydatidiform moles and choriocarcinomas?
a. atopic eruption of pregnancy
b. cholestasis of pregnancy
c. gestational pemphigoid
d. pruritic urticarial papules and plaques of pregnancy
e. toxic erythema of pregnancy
5. Intrahepatic cholestasis of pregnancy has been associated with:
a. fetal mortality as high as 13%
b. jaundice in 20% of cases
c. onset in the third trimester of pregnancy
d. recurrence in subsequent pregnancies
e. all of the above
Vulvar Diseases, Part 1
Medications in Dermatology, Part 2: Immunosuppressives
Atrophic Erythematous Facial Plaques
The Diagnosis: Atrophic Lupus Erythematosus
Cutaneous lupus erythematosus is divided into acute, subacute, and chronic cutaneous lupus erythematosus (CCLE). There are more than 20 subtypes of CCLE mentioned in the literature including atrophic lupus erythematosus (ALE).1 The most typical presentation is CCLE with discoid lesions. Most commonly, discoid CCLE is an entirely cutaneous process without systemic involvement.Discoid lesions appear as scaly red macules or papules primarily on the face and scalp.2 They may evolve into hyperkeratotic plaques with irregular hyperpigmented borders and develop a central hypopigmented depression with atrophy and scarring.2,3 Discoid CCLE has a female predominance and commonly occurs between 20 and 30 years of age. Triggers of discoid lesions include UV exposure, trauma, and infection.2
Our case of multiple atrophic plaques of the face, scalp, trunk, and upper extremities demonstrated a diagnostic challenge. Our patient presented with atrophic facial plaques, which are not typical of discoid lesions of CCLE. Our patient’s findings appeared clinically similar to acne scarring or atrophoderma. Histology showed common features of CCLE, including basal liquefactive degeneration, thickening of the basement membrane zone, increased melanin, and a lymphocytic inflammatory infiltrate (Figure).2,3 There was no evidence of hyperkeratosis, which often is seen in discoid lesions of CCLE.
Clinicopathologically, our case was consistent with ALE. A review of the literature revealed similar cases documented by Christianson and Mitchell4 in 1969; they described annular atrophic plaques of the skin of unknown diagnostic classification. Chorzelski et al5 reiterated the difficulty of defining diagnostically similar atrophic plaques of the face showing histopathologic features consistent with lupus and suggested these cases may represent an uncharacteristic presentation of discoid lupus erythematosus. Our patient demonstrated this rare subtype of discoid lupus erythematosus, known as ALE. There are few reports in the literature of ALE; thus we have managed our patient similar to other CCLE patients. Management of CCLE patients includes strict sun protection. Treatment options include corticosteroids, calcineurin inhibitors, antimalarial agents, and thalidomide.2 Our patient started using tacrolimus ointment 0.1% daily and hydroxychloroquine 200 mg twice daily. She also was practicing strict photoprotection. The patient was lost to follow-up. Topical steroids are not an option in ALE. It is important for dermatologists to recognize this rare variant of CCLE to prevent disfigurement.
1. Pramatarov KD. Chronic cutaneous lupus erythematosus—clinical spectrum. Clin Dermatol. 2004;22:113-120.
2. Rothfield N, Sontheimer RD, Bernstein M. Lupus erythematosus: systemic and cutaneous manifestations. Clin Dermatol. 2006;24:348-362.
3. Al-Refu K, Goodfield M. Scar classification in cutaneous lupus erythematosus: morphological description [published online ahead of print July 14, 2009]. Br J Dermatol. 2009;161:1052-1058.
4. Christianson HB, Mitchell WT. Annular atrophic plaques of the face. a clinical and histologic study. Arch Dermatol. 1969;100:703-716.
5. Chorzelski TP, Jablonska S, Blaszyczyk M, et al. Annular atrophic plaques of the face. a variety of atrophic discoid lupus erythematosus? Arch Dermatol. 1976;112:1143-1145.
The Diagnosis: Atrophic Lupus Erythematosus
Cutaneous lupus erythematosus is divided into acute, subacute, and chronic cutaneous lupus erythematosus (CCLE). There are more than 20 subtypes of CCLE mentioned in the literature including atrophic lupus erythematosus (ALE).1 The most typical presentation is CCLE with discoid lesions. Most commonly, discoid CCLE is an entirely cutaneous process without systemic involvement.Discoid lesions appear as scaly red macules or papules primarily on the face and scalp.2 They may evolve into hyperkeratotic plaques with irregular hyperpigmented borders and develop a central hypopigmented depression with atrophy and scarring.2,3 Discoid CCLE has a female predominance and commonly occurs between 20 and 30 years of age. Triggers of discoid lesions include UV exposure, trauma, and infection.2
Our case of multiple atrophic plaques of the face, scalp, trunk, and upper extremities demonstrated a diagnostic challenge. Our patient presented with atrophic facial plaques, which are not typical of discoid lesions of CCLE. Our patient’s findings appeared clinically similar to acne scarring or atrophoderma. Histology showed common features of CCLE, including basal liquefactive degeneration, thickening of the basement membrane zone, increased melanin, and a lymphocytic inflammatory infiltrate (Figure).2,3 There was no evidence of hyperkeratosis, which often is seen in discoid lesions of CCLE.
Clinicopathologically, our case was consistent with ALE. A review of the literature revealed similar cases documented by Christianson and Mitchell4 in 1969; they described annular atrophic plaques of the skin of unknown diagnostic classification. Chorzelski et al5 reiterated the difficulty of defining diagnostically similar atrophic plaques of the face showing histopathologic features consistent with lupus and suggested these cases may represent an uncharacteristic presentation of discoid lupus erythematosus. Our patient demonstrated this rare subtype of discoid lupus erythematosus, known as ALE. There are few reports in the literature of ALE; thus we have managed our patient similar to other CCLE patients. Management of CCLE patients includes strict sun protection. Treatment options include corticosteroids, calcineurin inhibitors, antimalarial agents, and thalidomide.2 Our patient started using tacrolimus ointment 0.1% daily and hydroxychloroquine 200 mg twice daily. She also was practicing strict photoprotection. The patient was lost to follow-up. Topical steroids are not an option in ALE. It is important for dermatologists to recognize this rare variant of CCLE to prevent disfigurement.
The Diagnosis: Atrophic Lupus Erythematosus
Cutaneous lupus erythematosus is divided into acute, subacute, and chronic cutaneous lupus erythematosus (CCLE). There are more than 20 subtypes of CCLE mentioned in the literature including atrophic lupus erythematosus (ALE).1 The most typical presentation is CCLE with discoid lesions. Most commonly, discoid CCLE is an entirely cutaneous process without systemic involvement.Discoid lesions appear as scaly red macules or papules primarily on the face and scalp.2 They may evolve into hyperkeratotic plaques with irregular hyperpigmented borders and develop a central hypopigmented depression with atrophy and scarring.2,3 Discoid CCLE has a female predominance and commonly occurs between 20 and 30 years of age. Triggers of discoid lesions include UV exposure, trauma, and infection.2
Our case of multiple atrophic plaques of the face, scalp, trunk, and upper extremities demonstrated a diagnostic challenge. Our patient presented with atrophic facial plaques, which are not typical of discoid lesions of CCLE. Our patient’s findings appeared clinically similar to acne scarring or atrophoderma. Histology showed common features of CCLE, including basal liquefactive degeneration, thickening of the basement membrane zone, increased melanin, and a lymphocytic inflammatory infiltrate (Figure).2,3 There was no evidence of hyperkeratosis, which often is seen in discoid lesions of CCLE.
Clinicopathologically, our case was consistent with ALE. A review of the literature revealed similar cases documented by Christianson and Mitchell4 in 1969; they described annular atrophic plaques of the skin of unknown diagnostic classification. Chorzelski et al5 reiterated the difficulty of defining diagnostically similar atrophic plaques of the face showing histopathologic features consistent with lupus and suggested these cases may represent an uncharacteristic presentation of discoid lupus erythematosus. Our patient demonstrated this rare subtype of discoid lupus erythematosus, known as ALE. There are few reports in the literature of ALE; thus we have managed our patient similar to other CCLE patients. Management of CCLE patients includes strict sun protection. Treatment options include corticosteroids, calcineurin inhibitors, antimalarial agents, and thalidomide.2 Our patient started using tacrolimus ointment 0.1% daily and hydroxychloroquine 200 mg twice daily. She also was practicing strict photoprotection. The patient was lost to follow-up. Topical steroids are not an option in ALE. It is important for dermatologists to recognize this rare variant of CCLE to prevent disfigurement.
1. Pramatarov KD. Chronic cutaneous lupus erythematosus—clinical spectrum. Clin Dermatol. 2004;22:113-120.
2. Rothfield N, Sontheimer RD, Bernstein M. Lupus erythematosus: systemic and cutaneous manifestations. Clin Dermatol. 2006;24:348-362.
3. Al-Refu K, Goodfield M. Scar classification in cutaneous lupus erythematosus: morphological description [published online ahead of print July 14, 2009]. Br J Dermatol. 2009;161:1052-1058.
4. Christianson HB, Mitchell WT. Annular atrophic plaques of the face. a clinical and histologic study. Arch Dermatol. 1969;100:703-716.
5. Chorzelski TP, Jablonska S, Blaszyczyk M, et al. Annular atrophic plaques of the face. a variety of atrophic discoid lupus erythematosus? Arch Dermatol. 1976;112:1143-1145.
1. Pramatarov KD. Chronic cutaneous lupus erythematosus—clinical spectrum. Clin Dermatol. 2004;22:113-120.
2. Rothfield N, Sontheimer RD, Bernstein M. Lupus erythematosus: systemic and cutaneous manifestations. Clin Dermatol. 2006;24:348-362.
3. Al-Refu K, Goodfield M. Scar classification in cutaneous lupus erythematosus: morphological description [published online ahead of print July 14, 2009]. Br J Dermatol. 2009;161:1052-1058.
4. Christianson HB, Mitchell WT. Annular atrophic plaques of the face. a clinical and histologic study. Arch Dermatol. 1969;100:703-716.
5. Chorzelski TP, Jablonska S, Blaszyczyk M, et al. Annular atrophic plaques of the face. a variety of atrophic discoid lupus erythematosus? Arch Dermatol. 1976;112:1143-1145.
A 26-year-old woman presented with a 2-year history of facial lesions that had gradually increased in size and number. Initially they were tender and pruritic but eventually became asymptomatic. She denied aggravation with sun exposure and did not use regular sun protection. Multiple pulsed dye laser treatments to the lesions had not resulted in appreciable improvement. Review of systems revealed occasional blurred vision and joint pain in her wrist and fingers of her right hand. Physical examination revealed a healthy-appearing woman. On the forehead and bilateral cheeks there were multiple atrophic, erythematous, sunken plaques with discrete borders. Each plaque measured more than 5 mm. Similar plaques were scattered across the frontal scalp, trunk, and upper extremities, though fewer in number and less atrophic with mild hyperpigmentation. There was diffuse hair thinning of the scalp. Laboratory test results included a normal complete metabolic panel, antinuclear antibody profile, and complete blood cell count. Histopathology revealed a superficial and mid perivascular and perifollicular inflammatory infiltrate composed of lymphocytes, histiocytes, and melanophages. Vacuolar changes in the dermoepidermal junction were present. There were few dyskeratotic keratinocytes and mucin deposition present in the dermis. Direct immunofluorescence was not performed.
Practice Question Answers: Deep Fungal Infections
1. The fungus classically associated with erythematous nodules along the lymphatics on the extremities is:
a. chromomycosis
b. coccidioidomycosis
c. mycetoma
d. paracoccidioidomycosis
e. sporotrichosis
2. The fungal infection that invades blood vessels of diabetics by broad nonseptate hyphae is:
a. aspergillosis
b. candidiasis
c. cryptococcosis
d. hyalohyphomycosis
e. zygomycosis
3. A rural farmer presents with verrucous plaques on his hand of several weeks’ duration. A biopsy revealed round, brown, pigmented bodies resembling copper pennies in the dermis. Which of the following is the most likely causative organism?
a. Blastomyces dermatitidis
b. Fonsecaea pedrosoi
c. Fusarium solani
d. Madurella mycetomi
e. Paracoccidioides brasiliensis
4. Mucicarmine is most helpful to identify gelatinous capsules in:
a. blastomycosis
b. candidiasis
c. cryptococcosis
d. mucormycosis
e. sporotrichosis
5. A student in a town near the Ohio River reports a headache, fever, nonproductive cough, and papular skin eruption. He has enjoyed the weekends exploring caves. The pathology from a skin biopsy showed small intracellular yeast forms with pseudocapsules. Which of the following is the most likely pathogen?
a. Aspergillus fumigatus
b. Coccidioides immitis
c. Histoplasma capsulatum
d. Paracoccidioides brasiliensis
e. Sporothrix schenckii
1. The fungus classically associated with erythematous nodules along the lymphatics on the extremities is:
a. chromomycosis
b. coccidioidomycosis
c. mycetoma
d. paracoccidioidomycosis
e. sporotrichosis
2. The fungal infection that invades blood vessels of diabetics by broad nonseptate hyphae is:
a. aspergillosis
b. candidiasis
c. cryptococcosis
d. hyalohyphomycosis
e. zygomycosis
3. A rural farmer presents with verrucous plaques on his hand of several weeks’ duration. A biopsy revealed round, brown, pigmented bodies resembling copper pennies in the dermis. Which of the following is the most likely causative organism?
a. Blastomyces dermatitidis
b. Fonsecaea pedrosoi
c. Fusarium solani
d. Madurella mycetomi
e. Paracoccidioides brasiliensis
4. Mucicarmine is most helpful to identify gelatinous capsules in:
a. blastomycosis
b. candidiasis
c. cryptococcosis
d. mucormycosis
e. sporotrichosis
5. A student in a town near the Ohio River reports a headache, fever, nonproductive cough, and papular skin eruption. He has enjoyed the weekends exploring caves. The pathology from a skin biopsy showed small intracellular yeast forms with pseudocapsules. Which of the following is the most likely pathogen?
a. Aspergillus fumigatus
b. Coccidioides immitis
c. Histoplasma capsulatum
d. Paracoccidioides brasiliensis
e. Sporothrix schenckii
1. The fungus classically associated with erythematous nodules along the lymphatics on the extremities is:
a. chromomycosis
b. coccidioidomycosis
c. mycetoma
d. paracoccidioidomycosis
e. sporotrichosis
2. The fungal infection that invades blood vessels of diabetics by broad nonseptate hyphae is:
a. aspergillosis
b. candidiasis
c. cryptococcosis
d. hyalohyphomycosis
e. zygomycosis
3. A rural farmer presents with verrucous plaques on his hand of several weeks’ duration. A biopsy revealed round, brown, pigmented bodies resembling copper pennies in the dermis. Which of the following is the most likely causative organism?
a. Blastomyces dermatitidis
b. Fonsecaea pedrosoi
c. Fusarium solani
d. Madurella mycetomi
e. Paracoccidioides brasiliensis
4. Mucicarmine is most helpful to identify gelatinous capsules in:
a. blastomycosis
b. candidiasis
c. cryptococcosis
d. mucormycosis
e. sporotrichosis
5. A student in a town near the Ohio River reports a headache, fever, nonproductive cough, and papular skin eruption. He has enjoyed the weekends exploring caves. The pathology from a skin biopsy showed small intracellular yeast forms with pseudocapsules. Which of the following is the most likely pathogen?
a. Aspergillus fumigatus
b. Coccidioides immitis
c. Histoplasma capsulatum
d. Paracoccidioides brasiliensis
e. Sporothrix schenckii