Dermpath Board Review Young Dermatologists’ Forum

Joshua M. Schulman, MD

Format

• 15 cases

• 30 seconds per question

• Review of answers at the end

Questions

1

1. This biopsy displays changes that were most likely induced by which virus? a. HSV1 b. HSV2 c. HPV1 d. HPV5 e. HPV16

10x 40x

2

2. What is the best diagnosis? a. Bullous lupus erythematosus b. Porphyria cutanea tarda c. Bullous pemphigoid d. Bullous solar elastosis e. Staphylococcal scalded skin syndrome

10x

3

3. What is the best diagnosis? a. Epithelioid cell histiocytoma b. Epithelioid hemangioendothelioma c. Nodular Kaposi sarcoma d. Superficial dermatofibrosarcoma protuberans e. Atypical fibroxanthoma

2x 40x

4

4. What is the best diagnosis? a. Cylindroma b. Spiradenoma c. Syringocystadenoma papilliferum d. Glomangioma e. Hidradenoma papilliferum

2x

5

5. What is the best diagnosis? a. Acantholytic squamous cell carcinoma in situ b. Pemphigus foliaceus c. Pemphigus vulgaris d. Darier’s disease e. Hailey-Hailey disease

20x 10x

6

6. What is the best diagnosis? a. Lipodermatosclerosis b. Lupus panniculitis c. Pancreatic panniculitis d. Subcutaneous fat necrosis of the newborn e. Reaction to poly-L-lactic acid injection

2x 10x

7

7. This material was found in the superficial dermis. What is the best diagnosis? a. Gouty tophus b. Calcinosis cutis c. Nodular amyloid d. Colloid milium e. Cautery artifact

10x

8

8. What is the best diagnosis? a. Myrmecia b. Tungiasis c. Scabies d. Dystrophic onychomycosis e. Cysticercosis

2x

9

9. What is the best diagnosis? a. Lichen planus b. Erythema multiforme c. Erythema migrans d. Fixed drug eruption e. Chronic graft-versus-host disease

4x 20x

10

10. What is the best diagnosis? a. Langerhans cell histiocytosis b. Compound melanocytic nevus c. Malignant melanoma d. Poroma e. Mastocytoma

4x 40x

11

11. What is the best diagnosis? a. Balloon cell melanocytic nevus b. Balloon cell melanoma c. Gout d. Eruptive xanthoma e. Nevus lipomatosus superficialis

4x 20x

12

12. What is the best diagnosis? a. Alopecia areata b. Lichen planopilaris c. Androgenetic alopecia d. Discoid lupus erythematosus e. Acne rosacea

4x 10x

13

13. What is the best diagnosis? a. Granular cell tumor b. Hibernoma c. Lipoblastoma d. Angiolipoma e. Liposarcoma

20x 40x

14

14. What is the best diagnosis? a. Interstitial granuloma annulare b. Metastatic breast carcinoma c. Angiosarcoma d. Bacillary angiomatosis e. Pyogenic granuloma

10x 40x

15

15. What is the best diagnosis? a. Nevus sebaceus b. Acne keloidalis nuchae c. Coccidioidomycosis d. Rhinosporidiosis e. Chromomycosis

2x 10x

Case Review

1. This biopsy displays changes that were most likely induced by which virus? a. HSV1 b. HSV2 c. HPV1 d. HPV5 e. HPV16

10x 40x

HSV/VZV HPV

“classic” subtypes

2. What is the best diagnosis? a. Bullous lupus erythematosus b. Porphyria cutanea tarda c. Bullous pemphigoid d. Bullous solar elastosis e. Staphylococcal scalded skin syndrome

10x

Bullous lupus

Neuts

Bullous pemphigoid

Eos

Bullous solar elastosis Staph scalded skin

3. What is the best diagnosis? a. Epithelioid cell histiocytoma b. Epithelioid hemangioendothelioma c. Nodular Kaposi sarcoma d. Superficial dermatofibrosarcoma protuberans e. Atypical fibroxanthoma

2x 40x

Epithelioid hemangioendothelioma

Kaposi sarcoma

“Superficial” DFSP Atypical fibroxanthoma

4. What is the best diagnosis? a. Cylindroma b. Spiradenoma c. Syringocystadenoma papilliferum d. Glomangioma e. Hidradenoma papilliferum

2x

Cylindroma Spiradenoma

Syringocystadenoma papilliferum Glomangioma

5. What is the best diagnosis? a. Acantholytic squamous cell carcinoma in situ b. Pemphigus foliaceus c. Pemphigus vulgaris d. Darier’s disease e. Hailey-Hailey disease

20x 10x

Acantholytic SCC Pemphigus foliaceus

Pemphigus vulgaris Darier disease

6. What is the best diagnosis? a. Lipodermatosclerosis b. Lupus panniculitis c. Pancreatic panniculitis d. Subcutaneous fat necrosis of the newborn e. Reaction to poly-L-lactic acid injection

2x 10x

Lipodermatosclerosis Lupus panniculitis

Subcutaneous fat necrosis of the newborn Sculptra granuloma

7. This material was found in the superficial dermis. What is the best diagnosis? a. Gouty tophus b. Calcinosis cutis c. Nodular amyloid d. Colloid milium e. Cautery artifact

10x

Gout Calcinosis cutis

Nodular amyloid Cautery artifact

8. What is the best diagnosis? a. Myrmecia b. Tungiasis c. Scabies d. Dystrophic onychomycosis e. Cysticercosis

2x

Myrmecia Scabies

Nail plate Cysticercosis

9. What is the best diagnosis? a. Lichen planus b. Erythema multiforme c. Erythema migrans d. Fixed drug eruption e. Chronic graft-versus-host disease

4x 20x

Lichen planus Erythema multiforme

Erythema migrans Chronic GVHD

10. What is the best diagnosis? a. Langerhans cell histiocytosis b. Compound melanocytic nevus c. Malignant melanoma d. Poroma e. Mastocytoma

4x 40x

LCH Compound melanocytic nevus

Melanoma Poroma

11. What is the best diagnosis? a. Balloon cell melanocytic nevus b. Balloon cell melanoma c. Gout d. Eruptive xanthoma e. Nevus lipomatosus superficialis

4x 20x

Balloon cell nevus Balloon cell melanoma

Gout Nevus lipomatosus

12. What is the best diagnosis? a. Alopecia areata b. Lichen planopilaris c. Androgenetic alopecia d. Discoid lupus erythematosus e. Acne rosacea

4x 10x

Lichen planopilaris Androgenetic alopecia

Discoid lupus Acne rosacea

13. What is the best diagnosis? a. Granular cell tumor b. Hibernoma c. Lipoblastoma d. Angiolipoma e. Liposarcoma

20x 40x

Granular cell tumor Lipoblastoma

Angiolipoma Liposarcoma

14. What is the best diagnosis? a. Interstitial granuloma annulare b. Metastatic breast carcinoma c. Angiosarcoma d. Bacillary angiomatosis e. Pyogenic granuloma

10x 40x

Interstitial GA Metastatic breast cancer

Bacillary angiomatosis Pyogenic granuloma

15. What is the best diagnosis? a. Nevus sebaceus b. Acne keloidalis nuchae c. Coccidioidomycosis d. Rhinosporidiosis e. Chromomycosis

2x 10x

Nevus sebaceus Coccidioidomycosis

Rhinosporidiosis Chromomycosis

Good luck!