Man with hand discoloration

33y, African-American man, working as a manager at Under-Armor, with h/o HTN, relatively well controlled on Labetalol, presents with the depigmentation on his hands. He has had this problems for a few years and has spread progressively.
Exam shows depigmented symmetrical macules on the extensor surface of his hands involving IP and MCP joints.
Which of the following statements is true?

1. The disease presents in the second-third decade of life with a 10-20% likelihood of spontaneous repigmentation- ANSWER.
2. It is likely that the patient has a genetic disorder with defective migration of melanocytes. He is likely to have a white forelock.
3. Antibodies to DNA topoisomerase II appear to be very prevalent in this disease.
4. The patient has lichen sclerosus
5. He could have had this secondary to exposure to certain chemicals at his job.

A man with a lesion in his ear

42 y, white man, with recurrent lt ear infections, h/o myringotomy in childhood, comes in c/o otalgia, purulent otorrhea, deafness, vertigo and constant headache. Exam findings are displayed in the picture
Owing to insurance issues, he hasn’t been seen by a physician for almost 2 years.

Which of the following statements is false?

1. It seems that he has otitis externa from this hearing aid, it needs to be replaced (Correct Answer)
2. He is likely to have conductive hearing loss
3. The pathology in the picture can herald the presence of a cholesteatoma
4. A CT scan of the temporal bone is a part of management of his current problem.
5. He needs a referral to the ENT specialist for surgical treatment

Identify the type of dermatitis

Case-A: 68y man who lays bricks and is exposed to several chemicals at work on a regular basis presents with a chronic pruritic rash on his left hand. Exam shows dry, erythematous skin with some fissures
Case-B: 55y man who recently bought a waist belt a few weeks ago presenting with a pruritic rash around his umbilicus. Exam shows a well demarcated erythematous rash with some superficial scabs formed after excessive scratching.

Which of the following statements is true?
1. Patient “A” has irritant” contact dermatitis while “B” has “allergic” contact dermatitis
2. Patient “A” has “allergic” contact dermatitis and “B” has “irritant” contact dermatitis.
3. Both patients have “allergic” contact dermatitis
4. Both patients have “irritant” contact dermatitis