1.

A 48-year-old man comes to the physician at his wifes insistence because of a mole on his
back. She says that the mole has grown larger over the past 6 months. Examination of the
skin shows a 0.7-cm, asymmetric, brown lesion; the lesion contains black and gray areas and
has an irregular border. What is the most appropriate next step in management?

DERMATOLOGY SET 1

DERMATOLOGY SET 1

DERMATOLOGY

2. A 62-year-old man comes to the physician because of a 1-day history of a painful rash on
his right side. He says that he first felt a burning sensation in the area, and then the rash
developed a day later. Examination of the skin shows multiple groups of erythematous
vesicles over the right flank.
a. What is the most likely diagnosis?
b. What is the most appropriate management?

3. A 40-year-old woman develops a pruritic rash on her wrists and shins. The rash is composed
of violaceous, polygonal papules. What is the most likely diagnosis?

4. A 63-year-old man comes to the physician because of a 2-week history of severe itching of
his skin. He says, My whole body itches except for my head. Its so bad that I cant sleep
at night. Examination of the skin shows multiple small, erythematous papules with the
occasional hemorrhagic crust. A 1-cm, gray-colored, raised track is found on the webbing
between his fingers. What is the best treatment for this patient?

[7]

DERMATOLOGY SET 1

5. A 2-month-old boy is brought to the physician by his aunt, who is babysitting him while
his parents are out of town. She is concerned that the boy is being abused. She says, When
I changed his diaper, I noticed a large bruise on his buttocks. He appears well-nourished
and is in no apparent distress. Physical examination shows an 8 x 10 cm blue-gray macule
over the lumbosacral region. There is no edema or tenderness to palpation. What is the most
appropriate next step in management?

6. A 56-year-old woman develops a painful rash 2 weeks after starting sulfasalazine for
ulcerative colitis. She says that the rash was preceded by fever, malaise and arthralgias.
Her temperature is 39.0C (102.2F), and pulse is 110/min. Physical examination shows
conjunctivitis, oral ulcers, and erythematous, target-like lesions on her face, trunk and
extremities. Over the next few days, bullous lesions develop, and the patients skin starts to
slough off.
a. What is the most likely diagnosis?
b. What is the appropriate management for this patient?

7. A 56-year-old man is started on intravenous vancomycin for suspected MRSA endocarditis.

Five minutes after the infusion is started, he develops a pruritic erythematous rash involving
his face, neck and upper body. What is the most appropriate next step in management?

[8]

DERMATOLOGY SET 1

8. What conditions are associated with erythema nodosum?

DERMATOLOGY

9. A 21-year-old man has an outbreak of genital herpes. One week later, he develops painful
oral erosions and a rash consisting of raised target lesions on his trunk and extremities.
What is the most likely diagnosis?

10. A 68-year-old woman with a history of varicose veins comes to the physician because of a
rash on her lower legs that has developed over the past 3 years. Physical examination shows
edema and an erythematous, hyperpigmented, scaling rash up to the mid-shins of the lower
extremities bilaterally. What is the most appropriate management?

[9]