Atopic Dermatitis

1.

A 1-year-old girl has a 3-month history of a very pruritic eruption, shown in this photo. Lesions are also present on the face and antecubital fossa. Of the following, the MOST likely diagnosis is:

a. Atopic dermatitis*

b. Allergic contact dermatitis

c. Psoriasis

d. Seborrheic dermatitis

e. Tinea corporis

2.

A 12-year-old girl presentswith erythematous, excoriated papules with overlying crust in the antecubital fossa (see photo). She showers daily and is using a petrolatum-based emollient twice a day. What is the most appropriate next step in management?

a. Decrease frequency of showers

b. Increase frequency of emollient application

c. Prescribe mupirocin ointment, topical, bid

d. Prescribe hydrocortisone 1% cream, topical, bid

e. Prescribe triamcinolone ointment 0.1%, topical, bid*

3.A 3 month-old baby has developed erythematous, oozing patches on the cheeks and chin and frequently rubs his face. Which of the following is the most likely diagnosis?

a. Atopic dermatitis*

b. Candidal dermatitis

c. Dyshidrotic dermatitis

d. Impetigo

e. Irritant Dermatitis

4.A 12 year-old boy with a long history of atopic dermatitis presents with a patch on the arm that is not improving despite two weeks of treatment with his usual class 3 topical corticosteroid. The area is open, oozing and has honey-colored crusting. Which of the following is the most likely diagnosis?

a. Atopic dermatitis

b. Candidal dermatitis

c. Dyshidrotic dermatitis

d. Impetigingized atopic dermatitis*

e. Irritant Dermatitis

5.A 14 year-old girl with a history of atopic dermatitis on the hands and wrists notes that she is using hydrocortisone 2.5% ointment twice daily every day and is only getting minimal relief. On exam, there is thick lichenification of the hands and wrists with many excoriations. What is the best next step?

a. Advise to stop all topical corticosteroids at this time.

b. Treat with an oral antibiotic for several weeks to exclude infection.

c. Advise daily dilute bleach baths to prevent infection.

d. Increase the potency of the topical steroid to fluocinonide given the location and thick lichenification.*

e. Decrease the potency of the topical steroid to hydrocortisone 1% cream to minimize the chance of steroid-related side effects.

6.The mother of a 2 year old with atopic dermatitis asks how frequently she should bathe her. What is the best answer?

a. Bathing is not recommend for children with atopic dermatitis.

b. Bathing once per week is optimal for children with atopic dermatitis.

c. Bathing once or even twice daily can be helpful in some cases, so long as gentle cleansers are used and moisturizers are applied immediately after bathing.*

d. Bathing 3-4 times daily is ideal for all patients with atopic dermatitis.

e. Bathing in salt water is the only acceptable way for patients with atopic dermatitis.

7.A 6 year-old girl with severe atopic dermatitis is using a class 2 topical steroid on the face and arms for 2-3 weeks out of every month and still having frequent flares. She has required 2 courses of oral corticorsteroids in the past 6 months for severe flares, and has had 4 courses of oral antibiotics in the past year. What is the next best step?

a. Order allergy testing.

b. Increase the strength of the patient’s antihistamine.

c. Refer the patient to a dermatologist for further evaluation and management.*

d. Initiate dilute bleach baths.

e. Stress improved moisturization.

8.A 3 year-old boy has ill-defined hypopigmented patches on the cheeks that seemed to appear over the summer. What is the best diagnosis?

a. Pityriasis rosea

b. Pityriasis alba*

c. Pityriasis versicolor

d. Tinea faceii

e. Keratosis pilaris