1. What proportion of American children have atopic dermatitis?
A. 5% to 10%
B. 9.5% to 12.5%
C. 12.5% to 17%
D. 17% to 20%
E. Unsure
2. Which of the following describes AD's different presentations over time?
A. Infantile, childhood, adult
B. Facial, dorsal, and upper back
C. Flexeral, perioral, and neck
D. Remitting, relapsing, and regressing
E. Unsure
3. Select the statement that is TRUE about guideline-directed care for children and adolescents.
A. Clinicians need to use guidelines that are specific to children and adolescents
B. The best guideline for children and adolescents are the SCORAD, EASI, and POEM
C. Guiding organizations advise clinicians to follow any guideline issued by any group
D. Clinicians should follow the AAD or the European Academy of Dermatology Guidelines
E. Unsure
4. Samantha is an 18 month old who has had AD since birth. After a long period of good control using daily bathing and moisturization 3 times a day, she is experiencing a flare primarily on her face. What is the next step according to the guidelines?
A. Topical low-potency corticosteroids twice daily
B. Topical high-potency corticosteroids 1 to 2 times weekly
C. Systemic cyclosporine weekly for 6 months
D. Dupilumab
E. Unsure
5. Samantha's mother returns 2 months later and says that Samantha's skin has worsened. She just realized that their daycare provider has not been applying the topical corticosteroid the doctor prescribed for maintenance. When she asked why, the daycare provider said, “Those ointments are dangerous. They ruin kids' skin and they can cause high blood sugar. The Internet says pimecrolimus is better.” What is the BEST next step?
A. Call the dermatologist and suggest she change Samantha's medication to methotrexate weekly for at least 8 weeks to ensure any response will be fast and enduring
B. Tell Samantha's mom that pimecrolimus causes skin malignancy and lymphoma and cannot be used on the face, groin, or axillary areas
C. Educate the mother and the caregiver about topical corticosteroids, and ensure that they both understand and can work out a schedule to improve adherence
D. Advise Samantha's mom to apply the topical corticosteroid just once daily after a bath, and that should be sufficient to get the AD back in control
E. Unsure
6. When thinking of possible treatments for AD, which of the following sets of words is correctly paired?
A. Cyclosporine—intravenous—age 12 and above
B. Crisaborole—topical—age 3 months and above
C. Dupilumab—oral—age 12 and above
D. Mycophenolate mofetil—subcutaneous—age 3 months and above
E. Unsure
7. Which of the following medications are FDA-approved for the treatment of AD in a child who is 6?
A. Pimecrolimus 0.1%, crisaborole, dupilumab
B. TCS, azathioprine, tacrolimus ointment 0.1%
C. Cyclosporine, methotrexate, dupilumab
D. TCS, mycophenolate mofetil, crisaborole
E. Unsure
8. Leo is a 9-year-old boy who has AD. His caregivers have been able to control his AD with fluocinolone acetonide ointment 0.025% until recently. He complains about the feel of the ointment, and applying it has been a struggle. Which of the following is TRUE?
A. Ointments are essential for children with AD because they are more occlusive than creams
B. Leo would probably be more adherent and have a better result if he switches to a solution or foam
C. At this age, most children's AD clears up, so a treatment-free trial is a good option
D. Patients typically prefer creams over ointments, and switching to a cream may improve adherence
E. Unsure
9. Charlotte is a 17-year-old adolescent who will be starting an immunomodulatory drug soon. She is sexually active and loves sunbathing on her family's sail boat. She also receives phototherapy and would like to continue. Which of the following immunomodulatory agents is most appropriate for her?
A. Cyclosporine
B. Azathioprine
C. Pimecrolimus
D. Dupilumab
E. Unsure
10. In a child who is 13 and weighs 63 kg, what maintenance dose of dupilumab is appropriate?
A. 200 mg every 2 weeks
B. 300 mg every 2 weeks
C. 300 mg every 4 weeks
D. 600 mg every 4 weeks
E. Unsure