Questions of the Week # 40, 41

Q40) A 17 year old boy is seen in your office for a recurrent rash on his back. He noticed that the rash became more obvious in summer as it shows up more prominently in his tanned skin.  He is concerned about his appearance and has stopped going to the beach in summer. He denies any itching or pain. He is sexually active and occassionally uses condoms. He denies alcohol or drug use. Physical examination reveals macular rash on his back as shown below.

I can't go to the beach!

The Most likely diagnosis:

A) Secondary Syphilis

B) Vitiligo

C) Pityriasis Rosea

D) Tinea Versicolor

E) Tinea Capitis

Q41) The most appropriate treatment for this patient’s condition:

A) Oral Prednisone

B) Topical Selenium Sulfide

C) Oral Flucnozole

D) Reassurance and observation

E) Topical Corticosteroid

F) Benzathine Penicillin Intramuscular

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19 Responses

  1. b,e

  2. D

  3. D, B

  4. C

  5. C) Pityriasis treat with B) Topical Selenium Sulfide

  6. D, B

  7. D

  8. Ans is D and B – Tinea versicolor , Tx is topical Selenium sulfide

  9. d and b

  10. D

  11. D B

  12. D

  13. D and B

    Tinea versicolor is caused by a yeast called Malassezia furfur that lives in the skin of most adults. This exists in two forms, one of which causes visible spots. Factors that can cause the fungus to become more visible include high humidity and immune or hormone abnormalities. However, almost all people with this very common condition are perfectly healthy.

    Because the tinea versicolor fungus is part of the normal adult skin, this condition is not contagious. It often recurs after treatment, but usually not right away, so that treatment needs to be repeated only every year or two.

    Tinea versicolor patches that are brown or reddish-brown go right away after treatment. When this condition produces spots that are lighter than the surrounding skin, it may take several months for overall color to even out. It always eventually does. Tinea versicolor does not leave permanent skin discoloration.

  14. Tinea versicolor treat with selenium sulfide
    nice twist to throw in the sexual habits…

  15. d

  16. DC

  17. D Tinea. versicolor
    C. Treatment is Fluconazole

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