TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 50: Pigmentation Changes Buttaro: Primary Care: A Collaborative Practice, 6th Edition MULTIPLE CHOICE 1. A parent reports the appearance of areas of depigmented skin on a child which has spread
rapidly. The provider notes asymmetrically patterned tri-colored, macules in a dermatomal distribution. What type of vitiligo does the provider suspect? a. Inflammatory vitiligo b. Segmented vitiligo c. Type A vitiligo d. Vitiligo with poliosis ANS: B
Segmented, or dermatomal vitiligo, spreads rapidly, is usually asymmetrical, and tends to occur in children. Inflammatory vitiligo occurs after inflammation of the skin. Type A vitiligo is non-dermatomal and is generally symmetric. Poliosis occurs when well-defined areas of white hair occur. 2. A patient who is diagnosed with vitiligo asks the provider what can be done to minimize the
contrast between depigmented and normal skin. What will the provider recommend? a. Applying a cosmetic cover-up or tanning cream b. Lightening the dark skin areas with hydrogen peroxide c. Tanning for limited periods in a tanning booth d. Waiting for all skin to become depigmented ANS: A
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Cosmetic cover-ups or tanning creams are useful to help darken affected areas. Hydrogen peroxide is not recommended. Tanning is contraindicated; excessive sunburn can stimulate depigmentation. Waiting for widespread depigmentation is unpredictable. 3. A patient diagnosed with well-localized vitiligo is referred to a dermatologist for treatment.
What will the initial treatment be? a. Chemical depigmentation with mequinol b. Narrow-band ultraviolet B light therapy c. Psoralens plus ultraviolet A light d. Twice-daily application of a mid-potency steroid cream ANS: D
The initial treatment for vitiligo is twice-daily mid-potency steroids. UVA and UVB therapy with psoralens may be used if this isn’t effective and must be performed by a qualified specialist. Patients with widespread areas of vitiligo may be treated with depigmentation therapy.
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