aloha residents

1. In what year did Hawaii enact legislation banning the sale of sunscreens containing oxybenzone and octinoxate due to their harmful effects on coral reefs?

ANSWER: 2018

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2. Which skin cancer is most commonly diagnosed in Hawaii?

ANSWER: Basal cell carcinoma

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3. Hawaii consistently records some of the highest annual UV index values in the U.S. What is the typical midday UV index in Honolulu on a clear day in July?

ANSWER: 10-11 Extreme or 12+ rare or unusual. Credit given to both answers since different sources report categories differently.

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4. What is the Hawaiian State Flower

ANSWER: Yellow Hibiscus

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5. Which population group in Hawaii is disproportionately affected by late-stage melanoma diagnoses?

ANSWER: Native Hawaiian/Pacific Islander. Native Hawaiian and Pacific Islander populations are more likely to be diagnosed with melanoma at a later stage. Contributing factors include reduced access to dermatologic care, underrepresentation in public health screening campaigns, and a misconception that darker skin is not at risk for skin cancer, which may delay diagnosis and treatment.

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6. What type of laser treatment is most effective in treating sun-related pigmentation issues like melasma or solar lentigines?

ANSWER: Picosecond Nd:YAG. Credit also given to Long pulse Nd:YAG.

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7. Which actinic neoplasm has been shown to occur with increased frequency among outdoor workers in Hawaii, particularly in sun-exposed areas like the ears, face, and forearms?

ANSWER: Squamous Cell Carcinoma

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8. Which Hawaiian Island Has The Highest Population?

ANSWER: Oahu

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9. A 26-year-old woman of Fitzpatrick skin type IV presents with atrophic acne scars and is interested in aesthetic treatment. She is concerned about PIH. Which of the following treatments is the most efficacious and safest first-line option for her?

ANSWER: Microneedling with radiofrequency (RF)

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10. A patient in Hawaii presents with chronic eczematous patches and a recent trip to a pig farm. Which of the following should be considered in the differential due to zoonotic transmission unique to tropical settings?

ANSWER: Tinea corpus from Trichophyton verrucosum

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11. What is the Lowest Temperature Ever Recorded in Oahu?

ANSWER: 52 degrees (some sites report 50 degrees)

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12.  In Hawaii, the prevalence of leprosy (Hansen’s disease) is historically higher than in most U.S. states. What is the most common presenting dermatologic manifestation in early disease?

ANSWER: Diffuse hypopigmented macules with sensory loss

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13. What is a key distinguishing dermoscopic feature of pigmented actinic keratosis (often seen in Hawaii) that helps differentiate it from lentigo maligna on chronically sun-damaged skin?

ANSWER: White circles

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14. A diver presents with linear, erythematous plaques and painful vesiculopustules on his shins one day after brushing against a coral reef. He reports the lesions have worsened despite topical corticosteroids. What is the most likely explanation?

ANSWER: Inoculation with marine toxins or nematocysts embedded in the skin 

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15. What is the only crop commercially grown in the United States that can be produced exclusively in Hawaii due to its tropical climate?

ANSWER: Cocoa (chocolate)

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16. Which two components were traditionally used in Hawaiian tattoo (kākau) ink, and what dermatologic reaction can they potentially cause today?

ANSWER: Kukui nut soot and sugarcane juice; risk of granulomatous reaction. Traditional Hawaiian tattooing (kākau) involved using soot from the kukui nut (candlenut tree, Aleurites moluccanus) mixed with candlenut oil or other plant-based binders.

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