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A life + dermatology application update If you’ve been following along here, you probably noticed things got a little quieter over the last few months. Not gone, just deeply, overwhelmingly full. So before we jump into what’s next, I wanted to take a moment to say: let me catch you up. The last 4–5 months have been some of the most intense, transformative, and growth-heavy months of my medical training so far. Audition Rotations: The Reality Behind the Highlight Reel This fall was dominated by audition rotations, which, if you know, you really know. Auditions are a strange mix of excitement and pressure. You’re rotating in places you admire, working with people who could become your future colleagues, while quietly carrying the weight of wanting to prove that you belong. Every day matters. Every interaction matters. You’re learning new systems, new expectations, new personalities, while still trying to be yourself. There were days I felt confident and energized, and days I went home replaying everything I said. I learned how important kindness, curiosity, humility, and consistency are sometimes even more than being the smartest person in the room. I learned how much culture matters. And I learned that the programs that felt the most “right” weren’t always the ones I expected on paper. Auditions taught me how I want to practice medicine, and just as importantly, who I want to become as a colleague and resident. The Application Season: Quietly Carrying Big Dreams Submitting dermatology applications is surreal. You spend years building toward something, condense it into PDFs and personal statements, and then… you wait. Waiting is harder than people admit. You keep showing up to rotations, studying, creating content, being a human, all while refreshing your email and trying not to read too deeply into silence. Interview invitations trickle in. You celebrate privately. You question yourself privately too. I learned that comparison steals joy fast during this season. Someone else’s timeline is not a verdict on your worth. Someone else’s success does not take away from your own path. Interviews: Seeing the Future Up Close Interview season has been both grounding and affirming. Each interview gave me a glimpse into different versions of my future: different cities, different patient populations, different ways of training. I met attendings who are deeply invested in education, residents who are kind and real, and programs that truly value mentorship. What surprised me most was how often interviews felt less like being evaluated and more like mutual discovery. Do our values align? Will I grow here? Can I be supported here? Some interviews felt immediately like home. Others taught me what I don’t want, which is just as important. Behind the Scenes: Still Creating, Still Growing Even when I wasn’t posting blogs as much, I was still creating. DalyDerm has continued to grow, from educational content, to skin-of-color advocacy, to the ongoing work behind Bridging the Gap: Daly’s Diverse Dermatology Dictionary. This project, in particular, has been a constant reminder of why I chose dermatology in the first place. Advocacy doesn’t pause for application cycles, and neither does purpose. What This Season Has Taught Me More than anything, the last few months have taught me this: You can work incredibly hard and still feel uncertain Confidence and humility can coexist Rest is not weakness, it’s a strategy You don’t have to share everything in real time to be doing meaningful work What’s Next As we move closer to Match season, I’ll be sharing more reflections, advice, lessons I wish I had known sooner, and honest conversations about the process. Not just the wins, but the growth in between. If you’re in this season too, auditioning, applying, interviewing, or simply wondering if you’re doing “enough”, I hope this reminds you that you’re not alone. Sometimes the quiet seasons are the ones building the strongest foundation. Thanks for being here. Truly. <3 Paige

Exam day has finally arrived! After months of preparation, it’s time to put everything into practice. I’ve learned that having a solid routine for the day of the exam—everything from what I wear to how I manage breaks—makes a huge difference in my performance and stress levels. Here’s my comprehensive guide to how I approach Step 2 CK exam day. Morning Routine: Starting Calm and Focused I wake up at 5:30 AM, giving myself plenty of time to get ready without rushing. Comfort is my top priority when choosing my outfit. I wear leggings, a simple t-shirt, and a zip-up jacket with minimal pockets. This outfit is cozy, non-restrictive, and easy to manage through security checks. Once dressed, I spend 30 minutes reviewing Anki cards and another 30 minutes going over my highlighted high-yield notes. This isn’t about learning new material but reinforcing key concepts to keep my mind sharp. For breakfast, I eat high-protein yogurt and drink my matcha + espresso beverage. I need something nutritious and filling but light enough to avoid any stomach discomfort during the exam. I plan to arrive at the testing center 30 minutes before the 8:00 AM start time. Arriving early helps me avoid last-minute stress and gives me a chance to settle in. What’s In My Bag: The Essentials That Keep Me Going Packing the right items is crucial. Here’s what I bring with me: Food Bag/Lunchbox: These snacks provide a mix of protein, carbs, and quick energy to keep me fueled during breaks. 2 protein bars 2 granola bars 2 fruit snacks 1 peanut butter sandwich Lululemon Bag: Thermos #1: Matcha + espresso (my morning and early exam caffeine fix) Thermos #2: Mt. Dew Zero Sugar (my second caffeine boost later in the day) Wallet & ID Passport (backup ID) Chapstick (dry lips are the worst!) Medicine pack: acetaminophen for headaches or any minor aches Kleenex Ear plugs (for noise control during breaks) Exam permit Tampons (just in case) Glasses (essential for clear vision) Hydration: I bring a large clear plastic water bottle with the label removed to stay hydrated throughout the day (I bring this into the test and leave at my desk). My Personal Exam Strategy: Staying Sharp and Sane Breaks: I take 5-7 minute breaks between each section. These moments help me reset mentally and physically. Desk Routine: When I leave my desk for breaks, I leave my zip-up jacket and glasses behind. This prevents me from wasting time checking these items in and out, saving precious minutes. Bathroom & Snacks: Every break, I head to the bathroom (small bladder, anyone?), drink some caffeine, and have a snack. This routine keeps me comfortable and energized. Posture: I consciously maintain good posture during the exam and stretch a bit during breaks. Sitting tall helps with focus and reduces fatigue. Positive Self-Talk: I remind myself, “You’ve got this!” and keep negativity at bay. Confidence is key. Prayer: I take quiet moments to pray and center myself. This spiritual practice calms my mind and strengthens my resolve. Final Thoughts Exam day is more than just answering questions—it’s about managing your energy, mindset, and comfort. Having a clear plan for what to wear, what to pack, and how to navigate breaks helps me stay calm and focused. If you’re preparing for Step 2 CK, I hope these tips give you some practical ideas and reassurance. You’ve worked hard—now it’s time to trust your preparation and show what you know!

Carrying the right items can turn a hectic audition day in dermatology into a smoother, more enjoyable experience. Here’s what I always pack in my beloved Poppy & Peonies tote —a bag that truly fits my life as a busy medical student in the clinic. https://us.poppyandpeonies.com/collections/totes/products/go-getter-tote-cognac Every morning starts with packing my non-negotiable supplies, ensuring I'm prepared for anything the day throws at me. Here are the key items I never leave home without: Lululemon Water Bottle (with a Lid): A must for staying hydrated, plus a lid or straw prevents any accidental spills. https://shop.lululemon.com/p/water-bottles/Back-To-Life-Sport-Bottle-MD/_/prod10390301?color=31382&sz=ONESIZE Vaseline (Pink!) and L’Oréal Paris Plump Ambition Lip Gloss: Hydrated, plump lips keep me comfortable and confident all day—thanks, sis, for the new favorite gloss! https://www.vaseline.com/us/en/p/vaseline-lip-therapy-rosy-mini.html/00305210231597 https://www.vaseline.com/us/en/p/vaseline-lip-therapy-rosy-lips-stick.html/00859581006853 https://www.lorealparisusa.com/makeup/lip-color/lip-gloss/plump-ambition-hyaluron-lip-oil-milky-nu-201 Medication Kit: I keep ibuprofen, Tums, and cough drops on hand for any sudden headaches or sore throats. Compact Umbrella: For surprise weather—nothing ruins a clinic day like being drenched. Fanny Pack with Wallet: When the day ends, I just grab my fanny pack (“belt bag” just doesn’t sound right) and leave the big tote behind. Study Materials: MedStudy Dermatology Core Book: My go-to in between patients for quick learning. No scrolling on my phone—looks much more professional. https://medstudy.com/collections/shop-all/products/medical-school-books Dermatology Pocket Guide, 5th Edition: Sometimes I seriously feel like a coach prepping my playbook! https://www.amazon.com/Dermatology-Dosing-Workup-Management-Card/dp/B074HG5FRC/ref=sr_1_19_sspa?crid=Z123YL7FCNI6&dib=eyJ2IjoiMSJ9.VI-DRhJHASRf1XGdhxSF5cSNcAaekNTYw-ifZl5o8nVUKhHZBzZECIESdX5D7Ee6P9Q6CrNwVp-4JtniaOWcR00QAuoLCZDsoxuCn-Nfck8LR2KYgeK3BMwku7woPFyLte_3DOf3Cioz4HL0zfkEDgiOMWSHzZLgSd0b72YLJct9sCXGFKFbNPb_6CQIbTFaV_LMdvW98YqG6ptAwxmJCOgu_LkqcVd4jXRuVkWGd2I.uMZmsB70UMIWU71OQlDtXSXE8o3xH8ftqBpG2sMm3ww&dib_tag=se&keywords=dermatology+pocket+guide&qid=1753487683&sprefix=dermatology+po%2Caps%2C178&sr=8-19-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9idGY&psc=1 English to Spanish Pocket Dermatology Guide by Dermlink Scholars: Perfect for bridging language gaps in patient care. https://www.medlinkscholars.com/store/p/english-to-spanish-dermatology-guide Derm Must-Haves: MadHippie Mineral-Based Sunscreen: Because being “sun smart” is foundational in dermatology! https://madhippie.com/collections/suncare/products/ultra-sheer-body-spf Coola Scalp Sunscreen Spray: Protects my scalp without leaving any greasy residue. https://coola.com/products/scalp-and-hair-spf-30-organic-sunscreen-spray Derm Samples (Cerave, Cetaphil, La Roche-Posay, Eucerin, Aquaphor): Not only for sharing with patients, but essential for myself too. Stationery: A collection of the best pens, a highlighter for my textbooks, and of course, my glasses—because reading tiny print and screens is a daily must. Technology: My laptop, charger, iPad, and AirPods are stowed and ready for studying and notes anytime a break pops up. Little Luxuries & Survival Tools: Stress Away Roll-On Essential Oil: My trick for stressful moments or particularly busy days. Gum: Great for freshening up between patient encounters. Extra Hair Ties and Tide To Go Pen: For high ponytail emergencies or inevitable coffee drips on my white coat. Food & Snacks: Packed Lunch: I always bring a PB&J sandwich, because it’s better to be prepared than to assume food will be available. High-Protein Snacks: Pistachios and sometimes an apple, and for breakfast, a high-protein yogurt and banana keep me fueled. Having these essentials in my tote makes every audition rotation less stressful and more enjoyable. My bag isn’t just for organization—it reflects how I bring a little fun, efficiency, and self-care to every clinic day. If you see me—and my overstuffed (but well-loved) Poppy & Peonies tote—no you didn't, hahah!

W Waardenburg Syndrome Etiology: mutations in genes involving the development of melanocytes + neural crest cells Inheritance : AD Appearance : patchy depigmentation of skin, hair Ass. conditions : deafness, heterochromia iridis Tx : no cure, sun protection, audiology exam Warfarin-induced skin necrosis Etiology: warfarin decreases protein C = poor inactivation of factor Va and VIIIa = hyper coagulable state Timing : first 2-5 days of starting warfarin Appearance : purport that becomes bluish-black with a red rim over a few days; blood blisters and full thickness skin necrosis follows Locations : extremities, breasts, trunk, penis Ass. conditions : protein C deficiency At risk: 50-70 yo, obese pts, perimenopausal women Tx : stop warfarin, Vitamin K reverses warfarin quicker, may require surgery or skin grafting Waterhouse-Friderichsen Syndrome (meningococcal disease) Etiology: Meningococcus which leads to adrenal hemorrhage, fulminant sepsis, and DIC Appearance : petechial or purpura that do not blanch Ass. sx : neck stiffness, HA, N/V, fevers, chills, irritability, seizure Location : begins on trunk or legs At risk : less than 4 yo, complement deficiencies, asplenic patients Tx : Penicillin, 3rd gen cephalosporin, IVF, NE, platelets Prog : if not treated quickly, pt may rapidly die A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

X Xanthoma Etiology: disorders of lipid metabolism (dyslipidemia) or occur in histiocytosis; accumulation of fat in macrophages Appearance : soft, yellow or skin colored papules or plaques Location/Types: medial canthus of upper eyelid = xanthelasma over pressure areas (knees, elbows, heels) = tuberous xanthoma extensor surfaces (buttock, shoulders) = eruptive xanthoma Tx: treat underlying dyslipidemia +/- chemical peels, electrodessication, cryo, excision Xeroderma Pigmentosum (XP) Etiology: mutation in nucleotide excision repair (NER) + UV rays Inheritance: AR Appearance : born with normal skin, but with increased sun exposure, patients develop hyperpigmented and hypo pigmented macules Location : sun exposed skin Tx : no cure, prevent UV exposure Prog : premature aging; die earlier from skin cancers Xerosis Cutis/Dry Skin Etiology: skin is lacking moisture in stratum corneum Appearance : rough, scaly plaque At risk : everyone 60+ yo, AD, hypothyroidism, CKD, weight loss Tx : moisturizers + emollients Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link 1/2 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

T Telangiectasia Etiology : UV light exposure, irradiation, trauma, topical glucocorticoids (atrophic skin) Description : spider veins (capillaries + venules) Associated with : Scleroderma (CREST) Telogen effluvium Etiology : illness, hospitalizations, preg, meds, surgeries Prog : resolves within 6-12 mo Thrombotic Thrombocytopenic purpura Etiology : excessive platelet activation and aggregation potentially due to (AR) genetic or acquired deficiency of ADAMTS13 (cleaves vWf) Description : Petechiae (small, flat, red spots) Purpura (red, purple larger spots) Tinea Etiology : dermatophytes Location/Appearance/Tx: Tinea corporis = body annular, scaly, erythematous plaques with slightly raised borders and partial central clearing topical antifungals (terbinafine) Tinea manuum = hand fine palmar scaling + dryness with redness topical antifungals (terbinafine) Tinea cruris = groin well demarcated scaly borders topical antifungals (terbinafine) + absorbant powders + loose undergarments Tinea capitis = scalp broken hairs resembling dots, a moth eaten appearance due to patchy hair loss oral griseofulvin Tinea pedis = foot silvery white scaling along soles or plantar surface topical antifungals (terbinafine) + powders Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link 1/2 Tinea Nigra Etiology : Hortaea werneckii Description : pigmented (gray to black) macules, irregular patches Location : palms + soles At risk : laborers in Africa, Asia, Central America, South America Toxic Shock Syndrome Etiology: S. aureus enterotoxin Type B or toxic shock syndrome toxin 1 (TSST-1) from tampons or other foreign objects located in the body for a long period of time Sx : fever, diffuse macular erythematous rash, low BP shedding of the skin in large sheets, especially from palms + soles, 1-2 weeks after the onset of illness Location : palms + soles Tx : supportive care + systemic abx Traction Alopecia Location : frontal hairline, sides Etiology : regularly wearing tight chignon, cornrows, dreadlocks, weaves, braids, hair extensions, and chemical relaxers and rollers Description : itching, redness, scaling, folliculitis, multiple short broken hairs, hair loss At risk : African American women Transient Neonatal Pusular Melanosis Etiology: Appearance: pustules that rupture leaving scale and PIH At risk : skin of color 1/4 Trichostasis Spinulosa Etiology: To play, press and hold the enter key. To stop, release the enter key. Trichotillosis/Trichotillomania Appearance : different lengths of hair in patch; have black dots from short hairs Trousseau’s Syndrome Etiology : people with occult or recently diagnosed visceral malignant disease (pancreatic cancer) Description : Lesions appear as inflamed, reddened lines or lumps in the fat under the skin Location : trunk or extremities Tuberous Sclerosis Etiology : mutation in TSC1 (hamartin), TSC2 (tuberin) Inheritance : AD Description : hypomelanotic macules / ash-leaf spots + angiofibroma (small bumps especially around nose + cheeks) shagreen patch Ash leaf marks Ash leaf marks Ash leaf marks Periungual fibroma Periungual fibroma Periungual fibroma Periungual fibroma Periungual fibroma Periungual fibroma Angiofibromas Angiofibromas Angiofibromas Angiofibromas Angiofibromas Angiofibromas Angiofibromas Angiofibromas Angiofibromas Angiofibromas Angiofibromas A B C D E F G H I J K L M N O P Q R S T U V W X Y Z