WBR0377

Author	PageAuthor::Mahmoud Sakr M.D.
Exam Type	ExamType::USMLE Step 2 CK
Main Category	MainCategory::Internal medicine
Sub Category	SubCategory::Dermatology
Prompt	[[Prompt::55 y/o male patient presents to your office with small bumps on his back that appeared slowly and increased in number over the past several months. He’s worried that those lesions might be cancer. Examination, reveal tan to brown raised lesions with a rough surface. A picture is shown Which of the following is the most likely diagnosis:]]
Answer A	AnswerA::Actinic keratosis
Answer A Explanation	[[AnswerAExp::Actinic keratosis (answer A) is a premalignant condition of thick, scaly, or crusty patches of skin. It is most common in fair-skinned people who are frequently exposed to the sun, because their pigment isn't very protective. It usually is accompanied by solar damage. Since some of these pre-cancers progress to squamous cell carcinoma, they should be treated.]]
Answer B	AnswerB::Seborrheic keratosis
Answer B Explanation	AnswerBExp::
Answer C	AnswerC::Seborrhoeic dermatitis
Answer C Explanation	[[AnswerCExp::Seborrhoeic dermatitis (answer C) is an inflammatory skin disorder affecting the scalp, face, and torso. Typically, seborrheic dermatitis presents with scaly, flaky, itchy, and red skin. It particularly affects the sebaceous-gland-rich areas of skin. In adolescents and adults, seborrhoeic dermatitis usually presents as scalp scaling similar to dandruff or as mild to marked erythema of the nasolabial fold]]
Answer D	AnswerD::Actinic cheilitis
Answer D Explanation	[[AnswerDExp::Actinic cheilitis (answer D) also known as solar cheilitis is the counterpart of actinic keratosis of the skin and can develop into squamous cell carcinoma. In actinic cheilitis, there is thickening whitish discoloration of the lip at the border of the lip and skin. There is also a loss of the usually sharp border between the red of the lip and the normal skin, known as the vermillion border.]]
Answer E	AnswerE::Pityriasis rosea
Answer E Explanation	AnswerEExp::Pityriasis rosea is a skin disease marked by patches of pink, oval rash of unknown etiology. Its appearance is very different from what’s shown here.
Right Answer	RightAnswer::B
Explanation	[[Explanation::Seborrheic keratosis resembles flattened or raised warts, but have no viral origins and may exhibit a variety of colors, from pink or yellow through brown and black. Because only the top layers of the epidermis are involved, seborrheic keratoses are often described as having a "stuck-on" appearance. Darkly pigmented lesions can be hard to distinguish from nodular melanomas. If in doubt, a skin biopsy should be performed. Educational Objective: References: ]]
Approved	Approved::Yes
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