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Billy Step 1 Questions # 59

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2K views 8 replies 7 participants last post by  rupesh 
#1 ·
A 50-year-old woman has been bothered by a discolored area of skin on her forehead that has not faded during the past
3 years. On physical examination, there is a 0.8-cm red, rough-surfaced lesion on the right forehead above the eyebrow. A
biopsy specimen examined microscopically shows basal cell hyperplasia. Some of the basal cells show nuclear atypia
associated with marked hyperkeratosis and parakeratosis with thinning of the epidermis. The upper dermal collagen and
elastic fibers show homogenization with elastosis. What is the most appropriate advice to give this patient?


□ (A) Reduce intake of dietary fat
□ (B) Wear a hat outdoors
□ (C) Stop taking aspirin for headaches
□ (D) Apply hydrocortisone cream to your face
□ (E) This condition is related to aging
 
#8 ·
B is correct

Actinic keratoses are premalignant lesions associated with sun exposure. Decreasing dietary fat is always a good
idea, but it does not have much effect on the skin of the face. Many drugs can cause acute eczematous dermatitis and
erythema multiforme. Hydrocortisone can alleviate the symptoms of many dermatologic conditions, but it cannot reverse
actinic damage. Older individuals are more likely to have actinic keratoses because of greater cumulative sun exposure,
not because of aging alone.
 
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