Dermatology

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Cutaneous Melanoma

Which one of the following statements about cutaneous melanoma is false?

  • Superficial spreading melanoma, is associated with signs of high cumulative sun damage.
  • Compared to the general population, solid organ transplant recipients have twice the incidence of melanoma.
  • One of the most important factors for identifying cutaneous melanoma is the ugly duckling sign.
  • The recommended width of excision for melanoma in situ is 5-mm margins.
Volume 41.2 - Question 20

Topical Acne Treatments

Which one of the following statements about the use of topical agents to treat acne vulgaris is false?

  • Daily sunscreen should be used concurrently with topical retinoids to protect against ultraviolet radiation damage.
  • Resistance to benzoyl peroxide is increasing in frequency.
  • Combining topical antibiotics with benzoyl peroxide improves efficacy.
  • Azeleic acid is the acne vulgaris treatment of choice during pregnancy.
Volume 41.2 - Question 19

Treatment of Acne Vulgaris

For the treatment of acne vulgaris, isotretinoin is unlikely to be associated with neuropsychiatric disorders.

  • True
  • False
Volume 41.2 - Question 18

Sunscreens

Which one of the following statements about sunscreens is false?

  • Benzene (a known carcinogen) has been found in some spray sunscreens.
  • Sunscreens should be used in infants < 6 months old.
  • Sunscreen sprays are flammable.
  • Oxybenzone can cause coral reef bleaching.
Volume 41.2 - Question 5

UV Radiation

Which one of the following statements about ultraviolet (UV) radiation is false?

  • UVA is largely responsible for the erythema of sunburn.
  • Both UVA and UVB radiation can cause skin cancer.
  • UVA unlike UVB is not filtered by clear glass.
  • UVA makes up 95% of terrestrial UV radiation.
Volume 41.2 - Question 4

Common White Lesions of the Oral Cavity

Persistent leukoplakia lesions in non-smokers tend to have a higher malignant transformation rate than similar lesions in smokers.  

  • True
  • False
Volume 40.5 - Question 32

PDE 4 Inhibitor

Which one of the following statements regarding the use of the topical phosphodiesterase-4 inhibitor roflumilast in dermatological conditions is false?

  • Regular blood work is required for monitoring.
  • It has received FDA approval for treatment of plaque psoriasis.
  • It has received FDA approval for seborrheic dermatitis.
  • Its safety profile encourages its long-term use as an alternative to corticosteroids.
Volume 40.4 - Question 26

DRESS

Which one of the following statements about drug reaction with eosinophilia and systemic symptoms is false?

  • The prodromal phase is typically followed by a morbilliform eruption that begins on the trunk.
  • Allopurinol has been associated with the shortest disease latency.
  • Atypical lymphocytosis is the earliest hematologic finding.
  • Systemic glucocorticoids are the mainstay of treatment for induction of remission.
Volume 40.4 - Question 24

Hidradenitis Suppurativa

More than half of patients with hidradenitis suppurativa have non-alcoholic fatty liver disease.

  • True
  • False
Volume 40.3 - Question 37

Treatment of Plaque Psoriasis

For the treatment of plaque psoriasis, a combination of calcipotriol (Dovonex) and betamethasone is more effective than betamethasone alone.

  • True
  • False
Volume 40.3 - Question 36

Chronic Urticaria

A 34-year-old patient presents to your office with a 3 month history of “hives”. There is a history of asthma but there are otherwise no medical concerns. After examination you diagnose chronic urticaria.
Volume 40.21 - Question 16

Hirsutism

A 20-year-old nulliparous, nulligravid female presents to your outpatient clinic concerned about unwanted facial and body hair growth. The hair growth began at 13 years of age – at the time of menarche. Her mother suffers from a similar pattern of hair growth. Further history-taking reveals that the patient does not have any significant associated symptoms. In particular, she describes regular menses and denies dysmenorrhea. She has not used any prescription medications over the last ten years. You examine her further to help determine the etiology of the hair growth. 
Volume 40.21 - Question 3

Chronic Urticaria

A 34-year-old patient presents to your office with a 3 month history of “hives”. There is a history of asthma but there are otherwise no medical concerns. After examination you diagnose chronic urticaria.
Volume 40.2 - Question 40

Skin Cancer in Darker Skin Tones

While it is well known that most skin cancers are more prevalent in lighter skin tones, people with darker skin tones experience increased morbidity and mortality from skin cancer.

  • True
  • False
Volume 40.2 - Question 2

Topical Anti-Inflammatory Treatments for Eczema

Which one of the following statements about topical anti-inflammatory treatments for eczema is false?

  • Tacrolimus 0.1% is more likely to cause application site reactions than pimecrolimus 1%.
  • There is no evidence for increased pigmentation changes with topical corticosteroids.
  • Longer term outcomes show increased skin thinning with mild topical corticosteroids compared to topical calcineurin inhibitors.
  • Crisaborole 2% and tacrolimus 0.1% are equally effective.
Volume 40.1 - Question 22

Scabies

Which one of the following statements about scabies is false?

  • Pruritus occurs about 4 to 6 weeks after initial infestation.
  • In residential care facilities with scabies outbreaks, half of residents may be asymptomatic.
  • Many patients with crusted scabies are immunosuppressed.
  • Oral ivermectin is more effective than topical permethrin.
Volume 40.1 - Question 21

Adult Female Acne

Spironolactone is more effective than doxycycline in the treatment of adult female acne.

  • True
  • False
Volume 40.1 - Question 2

Melanoma

Which one of the following statements is false?

  • There is sufficient evidence to support the effectiveness of skin cancer screening in reducing melanoma mortality.
  • Consistent sunscreen use does not meaningfully compromise vitamin D levels.
  • Immunotherapy is now the standard of care for patients with stage IV melanoma.
  • Patients who have a history of melanoma have a 4% to 8% risk of developing subsequent primary melanomas.
Volume 39.6 - Question 41

Rosacea Treatment

Which one of the following statements about the treatment of rosacea is false? 

  • Topical ivermectin is more effective than topical metronidazole for papulopustular rosacea.   
  • Oral antibiotics reduce telangiectasia.   
  • Isotretinoin reduces telangiectasia.   
  • Oral beta blockers can reduce flushing. 
Volume 39.5 - Question 39

Ultraviolet Exposure

Which one of the following statements about ultraviolet exposure is false?

  • Men experience more sunburns than do women.
  • Most skin cancers have been linked to ultraviolet exposure.
  • Umbrellas used as a shield against direct sunlight do not offer full protection against harmful radiation.
  • Pre-tanning in a tanning salon provides photo protection against additional DNA damage with further sun exposure.
Volume 35.61 - Question 4

Hirsutism

A 20-year-old nulliparous, nulligravid female presents to your outpatient clinic concerned about unwanted facial and body hair growth. The hair growth began at 13 years of age – at the time of menarche. Her mother suffers from a similar pattern of hair growth. Further history-taking reveals that the patient does not have any significant associated symptoms. In particular, she describes regular menses and denies dysmenorrhea. She has not used any prescription medications over the last ten years. You examine her further to help determine the etiology of the hair growth. 
Volume 39.4 - Question 43

Psoriasis Management

Which one of the following statements about the treatment of psoriasis is false? 

  • Topical treatments can be used for nail involvement if no more than two nails are involved.   
  • Calcineurin inhibitors may be used instead of corticosteroids in area of thinner skin as maintenance therapy.   
  • Narrowband UVB phototherapy is effective for plaques and diffuse guttate psoriasis that do not improve with topical treatments.   
  • Systemic agents should be considered when the involved body surface area exceeds 30%. 
Volume 39.4 - Question 40

Guttate Psoriasis

The differential diagnosis of guttate psoriasis includes the rash of secondary syphilis. 

  • True
  • False
Volume 39.4 - Question 39

Psoriasis

Which one of the following statements about psoriasis is false? 

  • Up to 30% of adults with plaque psoriasis develop psoriatic arthritis.   
  • Patients with type 2 diabetes have an increased risk of psoriasis.   
  • Obesity is a risk factor for psoriasis.   
  • Antibiotic treatments of streptococcal infections prevents progression of psoriasis. 
Volume 39.4 - Question 38

DRESS Syndrome

A 54-year-old female presents to your rural emergency department with a complaint of a new rash. She has a history of gout and has been started on allopurinol over the last few months.  She has a diffuse morbiliform rash, is febrile, and is found to have elevated LFTs and eosinophils. You suspect drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. 
Volume 38.21 - Question 18

Corticosteroids and Postherpetic Neuralgia

Administration of corticosteroids during acute herpes zoster infection has been found to decrease the likelihood of postherpetic neuralgia.

  • True
  • False
Volume 39.3 - Question 38

Acne

Which one of the following statements about the treatment of acne is false?

  • Concurrent application of dapsone and benzoyl peroxide can cause temporary yellow or orange discoloration of the skin and facial hair.
  • Concurrent application of tretinoin and benzoyl peroxide is recommended.
  • Drug-induced lupus and autoimmune hepatitis can occur with long-term use of minocycline.
  • Spironolactone is used off-label to treat acne in post-pubertal females.
Volume 39.3 - Question 37

Treatment for plantar warts

Which one of the following statements about the treatment of plantar warts is false?

  • There is not enough evidence on the efficacy of cryotherapy alone for the treatment of common warts.
  • Evidence for systemic treatment in plantar warts is scarce.
  • Salicylic acid had a better treatment response for plantar warts in comparison to cryotherapy.
  • High therapeutic success rate (75%-80%) was observed in the destructive treatment of plantar warts with CO2 laser and pulsed dye laser.
Volume 37.3 - Question 37

Skin cancer

Which one of the following antihypertensive medications is associated with increased rates of skin cancer in people over 65 years old? 

  • Angiotensin-converting enzyme inhibitors   
  • β-blockers   
  • Calcium channel blockers   
  • Thiazides 
Volume 36.6 - Question 36

Atopic Dermatitis

Which one of the following statements about atopic dermatitis is false? 

  • Lesions may be invisible in black patients.  
  • The area of skin covered by a child’s diaper is rarely involved.  
  • Persistent scratching leads to prurigo nodularis.   
  • Systemic immunosuppressants have been used to treat severe cases.
Volume 36.5 - Question 34

SAMP Hidradenitis Suppurativa

A 35-year-old female in your practice comes to see you for her routine pap test. While discussing her menstrual cycle she tells you with some embarrassment that she occasionally experiences painful lumps in the groin area that seem worse just before her period. This has been going on for a few years and seems worse since she had children as she wasn’t able to lose the baby weight. She is a smoker with a BMI of 30. You suspect hidradenitis suppurativa. 
Volume 36.4 - Question 47

Anal Fissure

Which one of the following statements about treatment of anal fissure is false?

  • Glyceryl trinitrate ointment is associated with a high withdrawal rate because of associated headache.
  • Tocopherol acetate ointment is associated with lower anal pain scores than glyceryl trinitrate ointment.
  • Tocopherol acetate ointment achieved a greater healing rate than glyceryl trinitrate ointment.
  • Tocopherol acetate ointment results in a higher recurrence rate 16 weeks after finishing the treatment than glyceryl trinitrate ointment.
Volume 37.6 - Question 22

Topical Acne Therapy

Which one of the following statements about topical acne treatments is false? 

  • Monotherapy with an antibiotic is not recommended because resistance can develop.     
  • Benzoyl peroxide can cause contact dermatitis.    
  • Benzoyl peroxide has not been shown to induce development of bacterial resistance.   
  • Concurrent application of tretinoin and benzoyl peroxide is recommended.  
Volume 36.4 - Question 42

Sunscreen 

Which one of the following statements about sunscreen use is false?  

  • It is not recommended for children under the age of six months.   
  • Some ingredients can reach blood levels that exceed recommended levels.   
  • It needs to be applied at least 30 minutes prior to sun exposure to be effective.   
  • Spray-on sunscreens tend to provide lesser protection compared to cream sunscreens. 
Volume 36.4 - Question 41

Hydrochlorothiazide and Skin Cancer

There is an increased risk of nonmelanoma skin cancer associated with the use of hydrochlorothiazide.  

  • True
  • False
Volume 36.3 - Question 38

Systemic Acne Therapy

Which one of the following statements about systemic acne therapy is false? 

  • Autoimmune hepatitis can occur with long-term use of minocycline.   
  • Minocycline may have a deleterious effect on spermatogenesis.   
  • Resistance is reported less frequently with erythromycin than tetracyclines.   
  • Trimethoprim/sulfamethoxazole should only be used when other antibiotics are ineffective. 
Volume 36.3 - Question 37

Sunscreen

Which one of the following statements about sunscreen use is false? 

  • It has been shown to reduce the incidence of basal cell carcinomas.   
  • It is effective in preventing the signs of photoaging.   
  • It significantly reduces the rate of actinic keratoses.   
  • It has been shown to reduce the incidence of invasive melanoma. 
Volume 36.3 - Question 4

Prevention of Eczema 

The daily use of emollient therapy by high risk children during the first year of life decreases the risk of developing eczema. 

  • True
  • False
Volume 36.1 - Question 35

Prevention of Eczema 

The daily use of emollient therapy by high risk children during the first year of life decreases the risk of developing eczema. 

  • True
  • False
Volume 36.1 - Question 35

Specific Dermatoses of Pregnancy

You are seeing a 29-year-old primiparous woman who is currently 34 weeks gestation in the office today. She has presented with complaints of a new itchy rash on her skin. While pre-existing skin conditions and non–pregnancy specific conditions such as psoriasis, urticaria, drug eruptions, contact dermatitis and scabies are important to consider, there is a specific group of conditions that the clinician should consider when assessing a pregnant woman presenting with pruritus alone or a pruritic rash.   
Volume 37.4 - Question 44

DRESS Syndrome

A 54-year-old female presents to your rural emergency department with a complaint of a new rash. She has a history of gout and has been started on allopurinol over the last few months.  She has a diffuse morbiliform rash, is febrile, and is found to have elevated LFTs and eosinophils. You suspect drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. 
Volume 38.1 - Question 37

Hidradenitis Suppurativa

A 25-year-old woman presents to your clinic with a recent fever and tender swelling and redness in her axilla. She reports she has experienced this a few times in the past associated with purulent drainage that resolved on its own. You suspect hidradenitis suppurativa (HS).
Volume 38.2 - Question 34

Bullous Pemphigoid

Which one of the following statements about bullous pemphigoid due to dipeptidyl-peptidase 4 (DPP4) inhibitors is false?

  • Median onset time from DPP4 inhibitor commencement is 11 months.
  • Skin biopsy is required for diagnosis.
  • Clinically, lesions are more widespread than traditionally described bullous pemphigoid.
  • Most patients with moderate to severe cases are sufficiently treated by potent topical corticosteroids.
Volume 37.5 - Question 29

Melanoma and UV Exposure

Which one of the following statements about melanoma is false?

  • Melanoma incidence in the US is more associated with UV radiation exposure than diagnostic scrutiny.
  • Cutaneous melanoma is now the third most commonly diagnosed cancer in the US.
  • The occurrence of melanoma is highly related to skin pigmentation.
  • Melanoma incidence across time is now 6 times as high as it was 40 years ago, with no concomitant rise in melanoma mortality.
Volume 38.4 - Question 32

Hidradenitis Suppurativa

There is a 3-fold greater risk of polycystic ovarian syndrome in patients with hidradenitis suppurativa.

  • True
  • False
Volume 38.4 - Question 31

Oral Minoxidil

Which one of the following statements about the use of oral minoxidil in the treatment of hair loss is false?

  • The dose used in hair loss is higher than the dose used for the treatment of hypertension.
  • It is as effective as topical minoxidil in improving hair density.
  • It has a higher incidence of adverse effects compared to topical minoxidil.
  • It should not be used in pregnancy.
Volume 38.4 - Question 25

Spironolactone

Spironolactone is an effective alternative to oral antibiotics for adult women with persistent acne who are not intending to become pregnant. 

  • True
  • False
Volume 39.1 - Question 37

Potassium Permanganate

Potassium permanganate is ineffective in the treatment of:

  • Diabetic foot ulcers
  • Contact dermatitis
  • Ulcerations in advanced cutaneous tumours
  • Dry skin
Volume 38.3 - Question 36

Acne Management

When treating acne vulgaris with oral antibiotics, combination therapy with topical benzoyl peroxide is recommended. 

  • True
  • False
Volume 39.1 - Question 25

Skin Conditions in Pregnancy

You are working in a busy prenatal clinic and several women present with concerns about skin conditions.
Volume 38.6 - Question 42

Eczema Management

Which one of the following statements regarding the use of topical steroids in the management of eczema is false?

  • High potency topical steroids are more effective than medium potency.
  • Medium potency topical steroids are more effective than low potency.
  • Weekend therapy is recommended to prevent relapse in those with frequent disease flare-ups.
  • Twice daily applications are no more effective than once daily applications.
Volume 38.6 - Question 2

Skin of Color: Essentials for the Non-Dermatologist

Which one of the following statements regarding dermatological conditions in patients with skin of color is false?

  • In patients of African descent, atopic dermatitis tends to affect the extensor surfaces.
  • Psoriatic plaques in skin of colour can appear violaceous or hyperpigmented with an overlying silvery scale.
  • Melanoma has a lower mortality rate in patients with skin of colour.
  • Keloidal scarring disproportionally affects individuals with skin of colour.
Volume 38.5 - Question 36

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