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MEHLMANMEDICALHY DERMATOLOGY
MEHLMANMEDICAL.COMMEHLMANMEDICAL.COM2HY DermatologyThis document is not designed to be a long-winded, 350-page dermatology textbook that caters to superfluousdetails that will never be tested. The focus here is to be as concise as possible with HY factoids in order toincrease your score on the USMLE.-Student Q showed 10M with scalp lesion similar to below, then the Q asked for the treatment:oAnswer = oral griseofulvin for patient only (also on FM NBME form); wrong answer = “oralgriseofulvin for patient and classmates”; Dx is tinea capitis; note alopecia and circular/scalyappearance of lesion; cause is dermatophytes (i.e.,Microsporum;Trichophyton).oQ on different NBME asks how to prevent; answer = “avoidance of sharing of hats”; “use ofmedicated shampoo” is wrong answer.-24M + itchy patches and greasy scales along the hairline; Q asks for the diagnosis:oAnswer = seborrheic dermatitis (dandruff); treatment = topical selenium or ketoconazoleshampoo; does not cause circular area of alopecia as with tinea capitis; more common inadults (tinea capitis more common in children); cause is inflammatory response to over-colonization withMalasseziayeast.oHigh prevalence in HIV patients; sudden onset in MSMàanswer = do HIV test.
MEHLMANMEDICAL.COMMEHLMANMEDICAL.COM3-46F + has three dogs at home; the following lesion from her forearm is shown; Q asks treatment:oAnswer = topical miconazole or clotrimazole; diagnosis = tinea corporis (ringworm); Q willoften mention dogs or use of yoga mats at the gym.-35F + BMI of 55 + type II diabetes + red, moist 8x12-cm ellipse under right breast; Q asks biggest riskfactor for her condition?àanswer = insulin resistance; obesity is wrong answer; diagnosis iscutaneous Candida; treat with oral fluconazole.-27F + white, cheese-like discharge per vaginum; Q asks what oral treatment she needs; answer =fluconazole; some students say, “Wait, I thought we use topical nystatin”àeither oral fluconazole ortopical nystatin can be used; there’s an NBME Q for Step 1 where they specify “oral” treatment;fluconazole is correct and nystatin isn’t listed.-32M + fever 101 F + red, itchy, scaly area between his 1stand 2ndtoes + the redness/scaling extendsup dorsum of foot and onto ankle; Q asks most likely causal organismfor his fever; answer =Staphaureus; Trichophytonis wrong answer; diagnosis is Staph cellulitis superinfection over tinea pedis;Staph can cause the fever; unlikely for tinea pedis in isolation to cause fever.oTx for tinea pedis on USMLE is topical terbinafine or -azole (i.e., clotrimazole/miconazole).-40F + diabetic foot ulcer; sterile probe to base of lesion is likely to show what?àcorrect answer onnew NBME exam = “polymicrobial”; wrong answers areStaph aureusandPseudomonas. This is anextremely important Q from NBME because people have long debatedStaphvsPseudomonasfordiabetic foot ulcers.

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Term
Fall
Professor
N/A
Tags
Usmle, Rash, Staphylococcus aureus

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