Hypopigmentation skin disorders: Clinical (To be retired)


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Hypopigmentation skin disorders: Clinical (To be retired)

Medicine and surgery

Allergy and immunology

Antihistamines for allergies


Cardiology, cardiac surgery and vascular surgery

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Hypertension: Clinical (To be retired)

Hypercholesterolemia: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Thiazide and thiazide-like diuretics

Calcium channel blockers

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Dermatology and plastic surgery

Hypersensitivity skin reactions: Clinical (To be retired)

Eczematous rashes: Clinical (To be retired)

Papulosquamous skin disorders: Clinical (To be retired)

Alopecia: Clinical (To be retired)

Hypopigmentation skin disorders: Clinical (To be retired)

Benign hyperpigmented skin lesions: Clinical (To be retired)

Skin cancer: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Dizziness and vertigo: Clinical (To be retired)

Hyperthyroidism medications

Hypothyroidism medications


Hypoglycemics: Insulin secretagogues

Miscellaneous hypoglycemics

Gastroenterology and general surgery

Gastroesophageal reflux disease (GERD): Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Diarrhea: Clinical (To be retired)

Malabsorption: Clinical (To be retired)

Colorectal cancer: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Anal conditions: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Breast cancer: Clinical (To be retired)

Laxatives and cathartics


Acid reducing medications

Hematology and oncology

Anemia: Clinical (To be retired)

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications

Infectious diseases

Pneumonia: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications



Miscellaneous antifungal medications

Anti-mite and louse medications

Nephrology and urology

Chronic kidney disease: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Urinary incontinence: Pathology review

ACE inhibitors, ARBs and direct renin inhibitors

PDE5 inhibitors

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Headaches: Clinical (To be retired)

Migraine medications

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Lung cancer: Clinical (To be retired)

Antihistamines for allergies

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Rheumatoid arthritis: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs


Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications

Osteoporosis medications


Hypopigmentation skin disorders: Clinical (To be retired)

USMLE® Step 2 questions

0 / 5 complete


USMLE® Step 2 style questions USMLE

of complete

A 56-year-old man of Nepalese origin attends the clinic complaining of skin rashes which have been troubling him for years. On examination, there are numerous poorly demarcated skin lesions present on all parts of the body. There is also evidence of significant facial thickening, eyebrow loss, and symmetrical sensory neuropathy in a 'glove and stocking' distribution. An examination of the hands reveals bilateral weakness. A skin biopsy is taken from one of the lesions and the culture is positive for acid-fast bacilli. Which of the following pharmacological therapies is involved in the treatment of this condition?


Content Reviewers

Rishi Desai, MD, MPH


Antonella Melani, MD

Kaylee Neff

Hypopigmentation refers to an area of skin becoming lighter than the baseline skin color due to a decreased amount of melanin pigment in the skin, which is produced by melanocytes.

Its most severe presentation is depigmentation, in which there’s absence of all pigment.

Most causes of hypopigmentation are not serious, and diagnosis can be made based upon a detailed history and physical examination, taking into account the course of the disorder, and lesion morphology, distribution, pattern, and extent of hypopigmentation, as well as additional cutaneous and extracutaneous signs and symptoms.

Individuals may be examined under a Wood's lamp, which emits low wave ultraviolet A light that allows a better visualization of variations in skin pigmentation. This is done in a darkened room with the Wood's lamp held at 4 to 5 inches from the skin, to observe any subsequent fluorescence.

Hypopigmented lesions emit a bright blue-white fluorescence and appear sharply delineated - the brighter they appear, the lower the amount of melanin pigment.

Examination under a Wood's lamp is especially helpful in fair skinned individuals to identify hypopigmented or depigmented lesions that may not be visible to the naked eye.

Finally, cases where the diagnosis is uncertain may get a skin biopsy to evaluate the number and location of melanocytes and melanin in the affected skin areas.

One of the most common and well known hypopigmentation disorders is vitiligo.

The exact cause isn’t known, but there’s an autoimmune destruction of melanocytes, leading to complete depigmentation of well defined patches that can range in size from millimeters to centimeters and can sometimes expand and merge with other patches over time.

These patches are classified into two broad categories. There’s non-segmental vitiligo, which is the more common type that affects any age group, and it occurs at various locations that are mirrored on both sides of the body.

Non-segmental vitiligo may progress and ultimately involve the whole body, which is called universal vitiligo.

And there’s also segmental vitiligo, the least common type of vitiligo, which mostly affects children, and occurs in segments along a single spinal nerve typically on only one side of the body without crossing the midline, particularly in the face following the trigeminal nerve.


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