A 23-year-old woman comes to the physician because of a 5-month history of a pruritic rash on the bilateral upper extremities. She has no history of serious illness and takes no medications. A skin biopsy of the rash shows intraepidermal accumulation of edematous fluid and widening of intercellular spaces between keratinocytes. Which of the following is the most likely diagnosis?
ADermatitis herpetiformis
BEczematous dermatitis
CAcanthosis nigricans
DLichen planus
EPsoriasis vulgaris
A 70-year-old man comes to the physician because of a painless skin lesion on his neck for the past 5 months. The lesion has gradually become darker in color and is often pruritic. He has a similar lesion on the back. He is a retired landscaper. He has smoked half a pack of cigarettes daily for 45 years. Physical examination shows a 0.9-cm hyperpigmented papule on the neck with a greasy, wax-like, and stuck-on appearance. Histopathologic examination is most likely to show which of the following?
ANests of melanocytes at the base of rete ridges and the dermis
BFibroblast proliferation with small, benign dermal growth
CS100-positive epithelioid cells with fine granules in the cytoplasm
DKoilocytes in the granular cell layer of the epidermis
EImmature keratinocytes with small keratin-filled cysts
A 65-year-old woman presents to a dermatology clinic complaining about a couple of well-demarcated, dark, round skin lesions on her face. She claims she has had these lesions for 3 or 4 years. The lesions are painless, not pruritic, and have never bled. However, she is moderately distressed about the potential malignancy of these lesions after she heard that a close friend was just diagnosed with a melanoma. The medical history is unremarkable. Physical examination reveals a few well-demarcated, round, verrucous lesions, with a stuck-on appearance, distributed on the patient's back and face (see image). Under a dermatoscope, the lesions showed multiple comedo-like openings, milia cysts, and a cerebriform pattern. What is the best next step of management?
AShave excision
BTopical fluorouracil
CCryotherapy
DExcisional biopsy
EReassure the patient and provide general recommendations
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