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Retired NBME 20 Answers

nbme20/Block 1/Question#5 (reveal difficulty score)
A 24-year-old African American man comes to ...
Pseudofolliculitis barbae ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: derm

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 +4  upvote downvote
submitted by โˆ—hayayah(1212)
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Foreign body inflammatory facial skin disorder characterized by firm, hyper-pigmented papules and pustules that are painful and pruritic. Located on cheeks, jawline, and neck.

Commonly occurs as a result of shaving (โ€œrazor bumpsโ€), primarily affects African-American males.

Images: shorturl.at/fpwY1

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tyggles  A good way to remember this is that the word Barber comes from the French for beard (barbe) and these rashes will be in the distribution of a beard. +4
fatboyslim  Also, it is unlikely to be acne vulgaris beginning at the age of 24 with only a 3-month history +7



 +4  upvote downvote
submitted by โˆ—hungrybox(1277)
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I did this by process of elimination:

Acne is not itchy or painful from my experience (Choice A).

Never heard of cutaneous lupus eryhtematosus, but I'd asssume you'd have a malar rash (involving the nose/undereye area), not spread out over the cheeks, jaw, and neck (Choice B).

Keloids are just overgrown scars. Scars are not particularly itchy or painful (Choice C)

Rosacea is just redness/flushing in certain areas of the skin. Mainly an aesthetic issue. Not itchy or painful (Choice E).

tbh I was between B and D.

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 +3  upvote downvote
submitted by โˆ—mrclean83(3)
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Black person here. Curly facial hair tends to curve back towards the skin a day or two after shaving. Hence the "pseudo" folliculitis. Not an infection but an inflammation from sharp edge of the hair growing into the skin. And yes it hurts! Generally sensitive to touch as well

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submitted by โˆ—lilyo(94)
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https://mybeardgang.com/pseudofolliculitis-barbae-treatment-tips-razor-bumps/

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 +0  upvote downvote
submitted by thegooddoctor(1)
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Pseudofolliculitis barbae is also extremely common in AA males. This should be another automatic reflex based on clinical presentation.

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