Hovik Ashchyan, MD

Board certified dermatologist and fellowship trained Mohs surgeon via @PennMedicine @UCSF and @MSKCancerCenter. Interested in medical education.

[John Barbieri, MD, MBA @DrJohnBarbieri]

🚨Attention Dermatology Residents🚨
Excited to share the 1st edition of our new comprehensive board review book, which includes >300 kodachromes and >800 practice exam questions designed to reflect the new board format. Also with lots fun memory aids!
https://t.co/ajCkZA3jvf

[Hovik Ashchyan, MD @HovAsh3]

EED has also been associated with strep infection, hep B, hep C, IBD, and rheumatologic diseases. But if the question comes up on an exam, they’re probably looking for HIV or IgA monoclonal gammopathy.

[Hovik Ashchyan, MD @HovAsh3]

Question #4! Answers posted the following day. #dermtwitter #dermatology #meded #MedTwitter

[Hovik Ashchyan, MD @HovAsh3]

Answer: C. The pathology image shows storiform fibrosis and neutrophils which is diagnostic for erythema elevatum diutinum (EED). Biopsy of an earlier lesion would have shown LCV. Strongest associations with EED are HIV infection and IgA monoclonal gammopathy.

[Hovik Ashchyan, MD @HovAsh3]

Answer: B, F, G. The image depicts the vesicular/inflammatory stage of incontinentia pigmenti (X-linked dom mutation in the IKBKG gene). Other than skin, IP also involves the teeth, eyes, and central nervous system.

[Hovik Ashchyan, MD @HovAsh3]

Question #3! This is an example of the type of question that comes up on the applied exam where you select multiple answers. #MedEd #dermtwitter #MedTwitter #dermatology

[Hovik Ashchyan, MD @HovAsh3]

@sherli_MD Dowling-Degos (reticular hyperpigmentation of skin folds) is a totally different diagnosis from Degos disease! Don’t get those confused.

[Hovik Ashchyan, MD @HovAsh3]

Question 2! #dermtwitter #MedTwitter #dermatology #MedEd

[Hovik Ashchyan, MD @HovAsh3]

Answer: C. The image depicts malignant atrophic papulosis (Degos disease), which is a small vessel vasculopathy. It presents with porcelain-white scars with erythematous rims. Bowel perforation and resulting peritonitis is a common cause of death.

[Hovik Ashchyan, MD @HovAsh3]

Important testable EN associations include: strep infection, GI infections (yersinia, campylobacter), sarcoidosis, IBD, and OCPs.

[Hovik Ashchyan, MD @HovAsh3]

#dermtwitter #dermatology #MedEd

[Hovik Ashchyan, MD @HovAsh3]

Answer: D. The patient is presenting with erythema nodosum. Since the patient didn’t respond to NSAIDs, the next best step in management would be to treat the underlying condition (Crohn disease in this case).

[Hovik Ashchyan, MD @HovAsh3]

I should mention, I have no relevant conflicts of interests and the questions will be written by me (not reposted from other resources).

[Hovik Ashchyan, MD @HovAsh3]

In my humble opinion, there are currently no great question banks to help residents prepare for the new ABD certification exams. I’ll be using this account to post weekly questions to help residents better prepare for the new exam style/content!

[Hovik Ashchyan, MD @HovAsh3]

#dermtwitter #dermatology #MedEd

[Hovik Ashchyan, MD @HovAsh3]

Guess I should start using my Twitter account…I’ll start by announcing that I graduated from dermatology residency @UCSF! Could not have asked for a better experience or mentors (@KanadeShinkai)! ❤️