Certified Dermatology Tech (CDT) — Questions and Answers

Question 1: When assisting with Mohs micrographic surgery, the CDT's role in tissue processing includes:

Diagnosing residual tumor margins
Selecting excision margins based on tumor size
Mapping and color-coding tissue specimens per Mohs protocol (Correct answer)
Interpreting the histologic sections

Correct answer: Mapping and color-coding tissue specimens per Mohs protocol

The CDT assists with mapping and color-coding Mohs tissue stages according to protocol, while diagnosis and margin interpretation are performed by the Mohs surgeon.

Question 2: During assessment of a wound, the technician identifies 'undermining.' This means:

Tissue destruction extends beneath intact skin surrounding the wound (Correct answer)
Wound exudate is purulent
The wound base is covered with eschar
Wound edges are rolled inward

Correct answer: Tissue destruction extends beneath intact skin surrounding the wound

Undermining describes tissue destruction that extends beyond the wound margins under intact-appearing skin, creating a pocket or cave-like area.

Question 3: Which layer contains blood vessels and nerves?

Dermis (Correct answer)
Stratum basale
Stratum corneum
Epidermis

Correct answer: Dermis

The dermis is the middle layer of the skin, located beneath the epidermis. It is rich in connective tissue, blood vessels, nerves, hair follicles, and glands, making it responsible for providing nutrients to the epidermis, regulating temperature, and mediating sensations.

Question 4: Which PPE item is considered the FIRST line of defense against contact transmission in a dermatology setting?

Gloves (Correct answer)
Gown
Face shield
N95 respirator

Correct answer: Gloves

Gloves are the primary barrier against contact transmission and must be worn when touching patients or potentially contaminated surfaces.

Question 5: What does patient-centered care involve?

Respecting and involving the patient (Correct answer)
Only technical performance
Ignoring emotional needs
Relying solely on medical advice

Correct answer: Respecting and involving the patient

Patient-centered care is an approach that prioritizes the patient's individual needs, preferences, and values in all clinical decisions. It involves actively listening to the patient, providing clear information, respecting their autonomy, and involving them as partners in their own care.

Question 6: What is the Koebner phenomenon?

Spontaneous resolution of skin lesions
Spread of infection through scratching
Development of skin lesions at sites of trauma in susceptible individuals (Correct answer)
Psoriasis flare triggered by stress

Correct answer: Development of skin lesions at sites of trauma in susceptible individuals

The Koebner (isomorphic) phenomenon refers to the appearance of skin lesions characteristic of a disease at sites of cutaneous trauma, seen in psoriasis, vitiligo, and lichen planus.

Question 7: How does risk management apply to daily practice in Dermatological Assessment Methods for Certified Dermatology Tech professionals?

Through proactive identification of potential hazards and implementation of preventive measures (Correct answer)
By avoiding high-risk situations entirely
Only through responding to incidents after they occur
Through annual safety audits exclusively

Correct answer: Through proactive identification of potential hazards and implementation of preventive measures

Effective risk management in Dermatological Assessment Methods requires proactive hazard identification and preventive measures, not just reactive responses. This approach reduces incidents, improves outcomes, and protects both professionals and clients.

Question 8: Which standard of practice is MOST important for ensuring quality in Laboratory Procedures & Biopsies?

Following evidence-based protocols while adapting to specific circumstances (Correct answer)
Using the most advanced technology available regardless of need
Minimizing documentation to focus on practical work
Strictly adhering to the same procedure in every situation

Correct answer: Following evidence-based protocols while adapting to specific circumstances

Evidence-based protocols provide a foundation of proven practices, but effective Certified Dermatology Tech professionals must also adapt their approach based on specific circumstances and individual case needs within Laboratory Procedures & Biopsies.

Question 9: In Skin Cancer Screening & Education, what is the FIRST step a CDT professional should take when encountering a new case or situation?

Document the situation and wait for further instructions
Consult with a supervisor before taking any action
Conduct a comprehensive assessment and gather all relevant information (Correct answer)
Implement an immediate solution based on past experience

Correct answer: Conduct a comprehensive assessment and gather all relevant information

In Skin Cancer Screening & Education, a thorough initial assessment ensures all relevant factors are identified before deciding on an appropriate course of action. This systematic approach is fundamental to Certified Dermatology Tech practice.

Question 10: Which of the following is the correct method for disposing of a used scalpel blade in a dermatology procedure room?

Use a needle-nose forceps or blade remover to remove the blade, then discard in a sharps container (Correct answer)
Wrap the blade in gauze and dispose in a biohazard bag
Remove the blade with fingers and place in a sharps container
Recap the blade and place in regular trash

Correct answer: Use a needle-nose forceps or blade remover to remove the blade, then discard in a sharps container

OSHA mandates that sharps never be recapped or handled by hand; a mechanical blade remover or forceps must be used to detach the blade, which is then deposited into a puncture-resistant sharps container.

Question 11: What is the purpose of using an autoclave?

For sterilization (Correct answer)
For drying instruments
To cool metal tools
For sharpening blades

Correct answer: For sterilization

An autoclave uses high-pressure saturated steam to achieve sterilization, effectively killing all forms of microbial life, including bacteria, viruses, fungi, and spores. This method is crucial in healthcare settings for rendering instruments and equipment safe for reuse, preventing the transmission of infections.

Question 12: What is the primary purpose of applying a topical corticosteroid under occlusion (covered with plastic wrap)?

To lower medication cost
To enhance drug absorption and penetration into the skin (Correct answer)
To maintain sterility of the wound site
To prevent the patient from scratching

Correct answer: To enhance drug absorption and penetration into the skin

Occlusive dressings increase local temperature and hydration, enhancing topical steroid absorption up to 100-fold by driving the drug deeper into skin layers.

Question 13: A 45-year-old patient has multiple skin-colored soft pedunculated growths in the axillae and neck folds. What are these lesions called?

Dermatofibromas
Lipomas
Neurofibromas
Acrochordonas (skin tags) (Correct answer)

Correct answer: Acrochordonas (skin tags)

Acrochordons (skin tags, or fibroepithelial polyps) are benign pedunculated growths commonly found in skin folds and areas of friction.

Question 14: The Langerhans cells found in the epidermis function primarily as:

Tactile receptors
Melanin producers
Keratin synthesizers
Antigen-presenting immune cells (Correct answer)

Correct answer: Antigen-presenting immune cells

Langerhans cells are dendritic antigen-presenting cells that play a key role in the skin's immune surveillance.

Question 15: Transmission-based precautions for varicella (chickenpox) in a dermatology clinic include:

Standard precautions only
Airborne and contact precautions (Correct answer)
Droplet precautions only
Contact precautions only

Correct answer: Airborne and contact precautions

Varicella spreads via both airborne droplet nuclei and direct contact with lesions, requiring both airborne and contact precautions.

Question 16: Which antibiotic class used in dermatology requires patients to use sunscreen due to photosensitivity?

Topical calamine lotion
Oral antihistamines
Topical hydrocortisone
Oral tetracyclines (doxycycline, minocycline) (Correct answer)

Correct answer: Oral tetracyclines (doxycycline, minocycline)

Oral tetracyclines cause photosensitivity reactions, requiring patients to apply broad-spectrum sunscreen and minimize direct sun exposure during treatment.

Question 17: In which phase of wound healing does angiogenesis primarily occur?

Hemostasis
Inflammatory
Proliferative (Correct answer)
Remodeling

Correct answer: Proliferative

Angiogenesis, the formation of new blood vessels, occurs primarily during the proliferative phase to support the growing granulation tissue.

Question 18: A healthcare worker with hand dermatitis tests positive to carba mix on patch testing. The most likely source of occupational exposure is:

Iodine-based wound care products
Surgical scrub solutions
Disinfectant cleaning solutions
Rubber examination gloves (Correct answer)

Correct answer: Rubber examination gloves

Carba mix contains carbamate accelerators used in rubber glove manufacturing, making examination gloves the primary occupational exposure source for healthcare workers.

Question 19: What is the role of sebaceous glands?

Sebum production (Correct answer)
Sweat production
Keratin production
Vitamin D synthesis

Correct answer: Sebum production

Sebaceous glands are exocrine glands found in the skin, primarily associated with hair follicles. Their main function is to produce and secrete sebum, an oily substance that lubricates the skin and hair, helping to keep them moisturized and protected.

Question 20: A dermatology patient is prescribed topical 5-fluorouracil (5-FU). This medication is used to treat:

Sebaceous cysts
Urticaria
Actinic keratoses and superficial basal cell carcinoma (Correct answer)
Bacterial skin infections

Correct answer: Actinic keratoses and superficial basal cell carcinoma

Topical 5-fluorouracil is a chemotherapeutic agent used for actinic keratoses and certain non-melanoma skin cancers by inhibiting DNA synthesis in rapidly dividing cells.

Question 21: Mast cells in the dermis play a central role in allergic and inflammatory skin reactions by releasing:

Collagen and elastin
Sebum and wax esters
Melanin and eumelanin
Histamine and other vasoactive mediators (Correct answer)

Correct answer: Histamine and other vasoactive mediators

Mast cell degranulation releases histamine, tryptase, and other mediators that cause vasodilation, increased vascular permeability, and pruritus in allergic reactions.

Question 22: A patient with acne is prescribed a topical retinoid. What is the primary mechanism of action of topical retinoids in treating acne?

Killing Cutibacterium acnes bacteria
Reducing sebum production
Blocking androgen receptors in sebaceous glands
Normalizing follicular keratinization (Correct answer)

Correct answer: Normalizing follicular keratinization

Topical retinoids normalize follicular keratinization, preventing the formation of microcomedones, which are the precursor lesion for all acne.

Question 23: Which ABCDE criterion was added later to supplement the original four criteria?

Border irregularity
Asymmetry
Diameter
Color variation
Evolving (Correct answer)

Correct answer: Evolving

The 'E' for Evolving was added to emphasize that any change in size, shape, color, or new symptoms warrants evaluation.

Question 24: Which situation constitutes a REPORTABLE ethical violation for a CDT?

Wearing gloves during non-invasive skin assessments
Using abbreviations in documentation
Performing a procedure outside the scope of practice without supervision (Correct answer)
Declining to discuss a colleague's patient without authorization

Correct answer: Performing a procedure outside the scope of practice without supervision

Performing procedures outside one's scope of practice without proper supervision is an ethical and legal violation that must be reported to the appropriate authority.

Question 25: When should a patient apply a topical medication prescribed 'twice daily'?

Whenever symptoms are most bothersome, up to twice
Only after bathing, twice per day
Only at morning and bedtime regardless of activities
At two evenly spaced intervals throughout the day (Correct answer)

Correct answer: At two evenly spaced intervals throughout the day

Twice daily dosing should ideally be spaced approximately 12 hours apart for consistent therapeutic drug levels in the skin.

Question 26: Which chemical is used as the neutralizing agent for glycolic acid and salicylic acid peels to stop the reaction once the desired endpoint is reached?

Hydrogen peroxide solution
Sodium bicarbonate solution or water rinse (Correct answer)
Acetone
Witch hazel

Correct answer: Sodium bicarbonate solution or water rinse

Sodium bicarbonate solution neutralizes glycolic acid by raising pH, while water dilutes and stops the reaction for both glycolic and salicylic acid peels.

Question 27: When setting up for electrodesiccation and curettage (ED&C), the grounding pad should be placed:

On a large, flat muscle mass away from the treatment site (Correct answer)
On the patient's chest
As close to the treatment site as possible
On the patient's forehead

Correct answer: On a large, flat muscle mass away from the treatment site

The grounding pad should be placed on a large, flat muscle mass (such as the thigh) to ensure proper electrical circuit completion and reduce the risk of burns.

Question 28: In cosmetic practice, platelet-rich plasma (PRP) is derived from which blood component and is used to stimulate collagen and tissue regeneration?

Serum with immunoglobulins removed
White blood cells filtered from whole blood
Plasma enriched with a high concentration of platelets and growth factors (Correct answer)
Red blood cells concentrated by centrifugation

Correct answer: Plasma enriched with a high concentration of platelets and growth factors

PRP is autologous plasma concentrated with platelets that release growth factors (PDGF, TGF-β, VEGF) upon activation, stimulating collagen synthesis and wound healing.

Question 29: Which oral antibiotic is most commonly prescribed to treat inflammatory acne in the US?

Amoxicillin
Doxycycline (Correct answer)
Ciprofloxacin
Vancomycin

Correct answer: Doxycycline

Doxycycline is the most widely prescribed oral antibiotic for inflammatory acne due to its combined antibacterial and anti-inflammatory properties against C. acnes.

Question 30: Erythema chronicum migrans, the hallmark rash of Lyme disease, is caused by which organism?

Treponema pallidum
Borrelia burgdorferi (Correct answer)
Bartonella henselae
Rickettsia rickettsii

Correct answer: Borrelia burgdorferi

Borrelia burgdorferi, transmitted by Ixodes ticks, causes the expanding annular 'bull's-eye' rash of Lyme disease known as erythema migrans.

Question 31: The Nikolsky sign is performed by applying lateral shear pressure to skin. A positive result suggests:

Epidermal–dermal adhesion defect (Correct answer)
Subcutaneous edema
Dermal fibrosis
Lichenification

Correct answer: Epidermal–dermal adhesion defect

A positive Nikolsky sign, where skin slides off with gentle pressure, indicates a defect in epidermal cohesion, as seen in pemphigus vulgaris and staphylococcal scalded skin syndrome.

Question 32: During wound care for a post-procedural dermatology patient, which dressing type creates a moist wound environment to promote healing?

Dry non-adherent dressing
Dry gauze dressing
Calcium alginate packing
Hydrocolloid dressing (Correct answer)

Correct answer: Hydrocolloid dressing

Hydrocolloid dressings maintain a moist wound environment, which accelerates re-epithelialization and reduces pain compared to dry dressings.

Question 33: What type of collagen predominates in the reticular dermis and provides tensile strength to the skin?

Type III collagen
Type VII collagen
Type I collagen (Correct answer)
Type IV collagen

Correct answer: Type I collagen

Type I collagen is the most abundant collagen in the reticular dermis and is responsible for the skin's tensile strength.

Question 34: Which ethical principle obligates the dermatology tech to act in the patient's best interest?

Justice
Non-maleficence
Beneficence (Correct answer)
Autonomy

Correct answer: Beneficence

Beneficence is the duty to actively promote and act in the patient's best interest, not merely to avoid harm.

Question 35: When a conflict arises between standard procedures and a unique situation in Dermatological Assessment Methods, what should a CDT professional prioritize?

Strict adherence to written procedures without exception
The preference of the client or stakeholder
The most cost-effective solution available
Safety and ethical obligations while seeking expert consultation (Correct answer)

Correct answer: Safety and ethical obligations while seeking expert consultation

Safety and ethics always take priority in Dermatological Assessment Methods. When standard procedures don't adequately address a unique situation, consulting with experienced colleagues or supervisors ensures both safety and professional standards are maintained.

Question 36: What mandatory US risk management program must patients and providers enroll in before isotretinoin can be prescribed?

FDA Fast Track designation
iPLEDGE REMS program (Correct answer)
Medicare Part D
HIPAA compliance program

Correct answer: iPLEDGE REMS program

The iPLEDGE REMS (Risk Evaluation and Mitigation Strategy) program is mandatory for isotretinoin because of its severe teratogenicity risk.

Question 37: What is the most common adverse effect of prolonged topical corticosteroid use on the face?

Skin atrophy and telangiectasias (Correct answer)
Antibiotic resistance
Hyperpigmentation
Increased facial hair growth

Correct answer: Skin atrophy and telangiectasias

Prolonged facial use of topical corticosteroids causes skin atrophy, visible telangiectasias, and perioral dermatitis due to chronic steroid effect on thin facial skin.

Question 38: What is the name of the intercellular junctions that link adjacent keratinocytes in the stratum spinosum?

Hemidesmosomes
Desmosomes (Correct answer)
Tight junctions
Gap junctions

Correct answer: Desmosomes

Desmosomes are strong intercellular junctions composed of desmogleins and desmocollins that physically connect adjacent keratinocytes and provide structural integrity.

Question 39: What is the purpose of the Wood's lamp examination in a dermatology laboratory setting?

To test skin sensitivity to allergens
To detect UV-fluorescent organisms or pigmentation changes (Correct answer)
To perform dermoscopy
To measure skin thickness

Correct answer: To detect UV-fluorescent organisms or pigmentation changes

Wood's lamp emits long-wave UV light (365 nm) that causes certain fungi, bacteria, and pigmentary conditions to fluoresce, aiding in diagnosis.

Question 40: Nikolsky's sign, where lateral pressure on intact skin causes blistering, is positive in which condition?

Epidermolysis bullosa acquisita
Pemphigus vulgaris (Correct answer)
Dermatitis herpetiformis
Bullous pemphigoid

Correct answer: Pemphigus vulgaris

Nikolsky's sign is positive in pemphigus vulgaris because acantholysis (loss of cell-cell adhesion) makes the epidermis fragile and easily displaced by shearing force.

Question 41: A patient reports a small bruise (ecchymosis) one day after hyaluronic acid lip augmentation. The most appropriate response is to:

Immediately inject hyaluronidase to reverse the filler
Apply a warm compress continuously for 48 hours
Schedule an emergency vascular occlusion workup
Reassure the patient that bruising is a common side effect and typically resolves in 7–14 days (Correct answer)

Correct answer: Reassure the patient that bruising is a common side effect and typically resolves in 7–14 days

Minor bruising is a common, expected side effect of filler injections; cold compresses and arnica can help, and the bruise typically resolves within two weeks.

Question 42: Which type of skin cancer most commonly arises from hair follicles and presents as a pearly, translucent nodule with rolled borders and telangiectasia?

Sebaceous carcinoma
Basal cell carcinoma (Correct answer)
Merkel cell carcinoma
Squamous cell carcinoma

Correct answer: Basal cell carcinoma

Basal cell carcinoma (BCC) arises from basal cells of the epidermis and pilosebaceous units, classically presenting as a pearly nodule with rolled edges and surface telangiectasia.

Question 43: Which skin structure serves as the primary barrier against ultraviolet radiation damage to deeper tissues?

Adipose tissue in the hypodermis
Melanin in the epidermis (Correct answer)
Elastic fibers in the dermis
Sebum on the skin surface

Correct answer: Melanin in the epidermis

Melanin pigment produced by melanocytes and transferred to keratinocytes forms a protective cap over keratinocyte nuclei, absorbing and scattering UV radiation.

Question 44: A newborn presents with a large, superficial blister that ruptures easily, leaving a moist denuded area. Gram stain shows gram-positive cocci in clusters. What is the most likely diagnosis?

Bullous impetigo
Epidermolysis bullosa
Staphylococcal scalded skin syndrome (Correct answer)
Pemphigus vulgaris

Correct answer: Staphylococcal scalded skin syndrome

Staphylococcal scalded skin syndrome in neonates is caused by exfoliative toxins from Staphylococcus aureus, causing widespread superficial blistering and desquamation.

Question 45: Which SPF rating is the minimum recommended by the American Academy of Dermatology for daily photoprotection?

SPF 50
SPF 100
SPF 30 (Correct answer)
SPF 15

Correct answer: SPF 30

The AAD recommends a broad-spectrum sunscreen of at least SPF 30 for adequate daily photoprotection against both UVA and UVB radiation.

Question 46: When a patient asks about the difference between UVA and UVB radiation regarding skin cancer risk, the most accurate response is:

UVB causes tanning, UVA causes sunburn; only UVA causes cancer
SPF ratings protect equally against both UVA and UVB
UVB primarily causes sunburn and direct DNA damage; UVA penetrates deeper and contributes to photoaging and cancer (Correct answer)
Only UVA radiation reaches the earth's surface

Correct answer: UVB primarily causes sunburn and direct DNA damage; UVA penetrates deeper and contributes to photoaging and cancer

UVB causes direct DNA damage and sunburn while UVA, which penetrates deeper into the dermis, contributes to photoaging and also to carcinogenesis.

Question 47: Pacinian corpuscles are mechanoreceptors that detect:

Pain and itch
Temperature changes
Deep pressure and vibration (Correct answer)
Light touch and texture

Correct answer: Deep pressure and vibration

Pacinian corpuscles are encapsulated nerve endings in the deep dermis and subcutis that respond to deep pressure and high-frequency vibration.

Question 48: Elastic fibers in the dermis are composed primarily of which protein?

Elastin (Correct answer)
Keratin
Collagen
Fibronectin

Correct answer: Elastin

Elastic fibers consist primarily of elastin protein cross-linked with fibrillin microfibrils, allowing the skin to stretch and recoil.

Question 49: The correct order for donning PPE before a dermatology procedure is:

Eye protection → gloves → gown → mask
Mask → gloves → gown → eye protection
Gloves → gown → mask → eye protection
Gown → mask/respirator → eye protection → gloves (Correct answer)

Correct answer: Gown → mask/respirator → eye protection → gloves

CDC guidance specifies gown first, then mask/respirator, then eye protection, then gloves to ensure the outer garment is secured before adding other protective items.

Question 50: When a conflict arises between standard procedures and a unique situation in Patient Education & Counseling, what should a CDT professional prioritize?

The most cost-effective solution available
Strict adherence to written procedures without exception
The preference of the client or stakeholder
Safety and ethical obligations while seeking expert consultation (Correct answer)

Correct answer: Safety and ethical obligations while seeking expert consultation

Safety and ethics always take priority in Patient Education & Counseling. When standard procedures don't adequately address a unique situation, consulting with experienced colleagues or supervisors ensures both safety and professional standards are maintained.

Question 51: Which document grants a healthcare proxy the authority to make medical decisions for an incapacitated dermatology patient?

HIPAA release form
Living will
Do-not-resuscitate order
Durable power of attorney for healthcare (Correct answer)

Correct answer: Durable power of attorney for healthcare

A durable power of attorney for healthcare designates a specific individual to make medical decisions when the patient is unable to do so.

Question 52: During a skin assessment, a technician notes 'telangiectasias.' These are best described as:

White macular lesions indicating depigmentation
Dilated superficial blood vessels visible through the skin (Correct answer)
Small subcutaneous hemorrhages
Yellow fatty deposits beneath the skin

Correct answer: Dilated superficial blood vessels visible through the skin

Telangiectasias are permanently dilated small superficial blood vessels visible as red or purple linear marks on the skin surface.

Question 53: What is the first step before performing any dermatologic procedure?

Put on gloves
Document patient history
Sanitize the equipment
Wash hands thoroughly (Correct answer)

Correct answer: Wash hands thoroughly

Handwashing is the single most important measure to prevent the spread of infection in healthcare settings. Before any patient contact or procedure, thorough hand washing with soap and water or using an alcohol-based hand rub is essential to remove transient microorganisms.

Question 54: What is the primary function of the skin's stratum corneum?

Barrier against water loss and pathogens (Correct answer)
Melanin production
Immune surveillance
Sensory reception

Correct answer: Barrier against water loss and pathogens

The stratum corneum consists of dead, flattened corneocytes embedded in lipid lamellae that form the primary barrier against transepidermal water loss and external pathogens.

Question 55: A patient presents for a consultation on dermal fillers and reports taking aspirin daily for cardiac prophylaxis. Which is the most appropriate next step?

Reschedule the patient indefinitely
Advise stopping aspirin 2 weeks before the procedure
Proceed with filler since aspirin is OTC
Document the medication and inform the supervising physician (Correct answer)

Correct answer: Document the medication and inform the supervising physician

The dermatology tech's role is to document all medications and relay the information to the physician, who will determine if anticoagulant management is needed.

Question 56: Which biologic medication targets IL-17A and is approved for the treatment of moderate-to-severe plaque psoriasis?

Adalimumab (Humira)
Ustekinumab (Stelara)
Dupilumab (Dupixent)
Secukinumab (Cosentyx) (Correct answer)

Correct answer: Secukinumab (Cosentyx)

Secukinumab (Cosentyx) is a monoclonal antibody that specifically targets IL-17A, a key cytokine in the inflammatory pathway of psoriasis.

Question 57: The gold standard debridement method that allows selective tissue removal under direct visualization is:

Mechanical debridement
Autolytic debridement
Sharp/surgical debridement (Correct answer)
Enzymatic debridement

Correct answer: Sharp/surgical debridement

Sharp or surgical debridement allows precise removal of devitalized tissue under direct visualization and is considered the gold standard.

Question 58: A 65-year-old with a history of sun exposure presents with a rough, scaly lesion on the face. Biopsy reveals atypical keratinocytes in the epidermis without invasion. What is the diagnosis?

Bowen's disease
Squamous cell carcinoma
Keratoacanthoma
Actinic keratosis (Correct answer)

Correct answer: Actinic keratosis

Actinic keratosis (solar keratosis) shows atypical keratinocytes confined to the epidermis, making it a precancerous lesion rather than frank carcinoma.

Question 59: A patient presents with well-demarcated, erythematous plaques covered with silvery-white scales on the elbows and knees. Which condition is most likely?

Psoriasis vulgaris (Correct answer)
Pityriasis rosea
Nummular eczema
Seborrheic dermatitis

Correct answer: Psoriasis vulgaris

Psoriasis vulgaris characteristically presents with well-demarcated erythematous plaques with silvery-white scales on extensor surfaces like elbows and knees.

Question 60: What is the primary function of the dermis?

Barrier formation
Fat storage
Vitamin D synthesis
Support and nourishment (Correct answer)

Correct answer: Support and nourishment

The dermis is the thick, middle layer of the skin, located beneath the epidermis. It provides structural support to the skin through its rich network of collagen and elastin fibers, giving skin its strength and elasticity. Additionally, it contains blood vessels that supply nutrients and oxygen to the avascular epidermis, as well as nerves, hair follicles, and glands.

Question 61: What is one primary goal of infection control protocols?

Improve comfort of tools
Prevent disease transmission (Correct answer)
Reduce noise in the clinic
Save time during cleaning

Correct answer: Prevent disease transmission

The overarching goal of infection control protocols in any healthcare setting is to prevent the spread of infectious diseases among patients, staff, and visitors. These protocols encompass a range of practices designed to break the chain of infection and maintain a safe environment.

Question 62: Which assessment technique is used to determine if a lesion is pulsatile or compressible in order to differentiate vascular from non-vascular lesions?

Diascopy with glass slide
Auscultation
Punch biopsy
Palpation with single-finger compression (Correct answer)

Correct answer: Palpation with single-finger compression

Palpation with single-finger compression determines whether a lesion is compressible (emptying under pressure), which suggests a vascular lesion like a hemangioma.

Question 63: The Bloodborne Pathogens Standard (29 CFR 1910.1030) is enforced by which federal agency?

FDA
OSHA (Correct answer)
EPA
CDC

Correct answer: OSHA

OSHA enforces the Bloodborne Pathogens Standard, which mandates exposure control plans and protective measures for healthcare workers.

Question 64: What does HIPAA protect?

Provider salary
Patient health information (Correct answer)
Medical billing formats
Clinic design

Correct answer: Patient health information

HIPAA (Health Insurance Portability and Accountability Act) is a federal law designed to protect the privacy and security of patient health information. It sets national standards for the protection of sensitive patient data, ensuring confidentiality and regulating how healthcare providers handle and share this information.

Question 65: How long before PDT light activation is aminolevulinic acid (ALA) typically applied?

24 hours
1–3 hours (Correct answer)
30 minutes
5 minutes

Correct answer: 1–3 hours

ALA is applied 1–3 hours before light activation to allow adequate uptake and concentration in target abnormal cells.

Question 66: Which hallmark sign is used to diagnose pemphigus vulgaris at the bedside, where lateral pressure on unblistered skin causes shearing of the epidermis?

Fitzpatrick sign
Asboe-Hansen sign
Darier sign
Nikolsky sign (Correct answer)

Correct answer: Nikolsky sign

A positive Nikolsky sign, elicited by applying lateral shear pressure to normal-appearing skin to produce blistering, is characteristic of pemphigus vulgaris.

Question 67: A sharps container should be replaced when it reaches what fill level?

50% full
100% full
75% full (Correct answer)
25% full

Correct answer: 75% full

Sharps containers should be sealed and replaced when they reach 75% capacity to prevent overfilling and needlestick injuries during disposal.

Question 68: A wound with purulent drainage, periwound erythema extending more than 2 cm, warmth, and fever most likely indicates:

Normal inflammatory healing
Wound dehiscence
Wound colonization
Wound infection (Correct answer)

Correct answer: Wound infection

Purulent drainage combined with spreading erythema >2 cm, warmth, and systemic signs like fever indicates wound infection requiring treatment.

Question 69: Apocrine sweat glands are primarily located in which body areas?

Palms and soles
Axillae and groin (Correct answer)
Back and chest
Forehead and upper lip

Correct answer: Axillae and groin

Apocrine glands are concentrated in the axillae, groin, and areolae, becoming active after puberty and producing a thicker secretion associated with body odor.

Question 70: In the PUSH tool (Pressure Ulcer Scale for Healing), which three parameters are scored?

Stage, wound age, and periwound condition
Depth, undermining, and pain level
Color, odor, and temperature
Length x width, exudate amount, and tissue type (Correct answer)

Correct answer: Length x width, exudate amount, and tissue type

The PUSH tool scores wound surface area (length x width), amount of exudate, and wound tissue type to track healing progression.

Question 71: Which systemic dermatologic medication requires monthly monitoring of liver function tests and fasting lipid panels?

Oral antihistamine
Topical tretinoin
Topical clindamycin
Oral isotretinoin (Correct answer)

Correct answer: Oral isotretinoin

Isotretinoin can elevate liver enzymes and triglycerides, requiring monthly blood monitoring of liver function and lipid levels throughout treatment.

Question 72: The papillary dermis differs from the reticular dermis in that it contains:

Adipocytes and large vessels
Thick elastic fibers only
Loose connective tissue and capillary loops (Correct answer)
Densely packed Type I collagen bundles

Correct answer: Loose connective tissue and capillary loops

The papillary dermis is composed of loose connective tissue with capillary loops that nourish the avascular epidermis.

Question 73: Hand hygiene should be performed for a minimum of how many seconds when using soap and water?

60 seconds
40 seconds
20 seconds (Correct answer)
10 seconds

Correct answer: 20 seconds

CDC guidelines recommend at least 20 seconds of hand washing with soap and water to mechanically remove and kill transient microorganisms.

Question 74: Which is a breach of ethical conduct in dermatology care?

Respecting patient privacy
Providing educational brochures
Discussing a patient case publicly (Correct answer)
Documenting consent forms

Correct answer: Discussing a patient case publicly

Discussing a patient case publicly is a direct breach of patient confidentiality and ethical conduct. Healthcare professionals are bound by strict privacy rules, such as HIPAA, to protect sensitive patient information, and public disclosure violates trust and legal obligations.

Question 75: How long should standard patch tests remain in place before removal and the first reading?

24 hours
48 hours (Correct answer)
72 hours
96 hours

Correct answer: 48 hours

Standard patch tests are left in place for 48 hours before removal and initial reading per international patch testing guidelines.

Question 76: During skin cancer screening, a technician uses total body skin examination (TBSE). The correct sequence for a systematic examination is:

Begin with the trunk and extremities, skip mucosal surfaces
Examine areas of chief complaint first, then the rest of the body
Start at the scalp and work systematically downward to the feet (Correct answer)
Examine only sun-exposed areas unless patient requests more

Correct answer: Start at the scalp and work systematically downward to the feet

TBSE follows a systematic head-to-toe approach starting at the scalp and proceeding downward to ensure no body surface area is missed.

Question 77: Which layer of the skin is responsible for waterproofing and protection?

Dermis
Epidermis (Correct answer)
Subcutaneous layer
Basement membrane

Correct answer: Epidermis

The epidermis is the outermost layer of the skin, primarily composed of keratinocytes. These cells produce keratin, a tough, fibrous protein that forms a protective barrier against physical damage, pathogens, and UV radiation. The stratum corneum, the outermost part of the epidermis, is particularly rich in keratin and lipids, providing the essential waterproofing function.

Question 78: A parent asks how to recognize signs of an allergic contact dermatitis reaction versus an irritant contact dermatitis reaction in their child. Which characteristic is more typical of allergic contact dermatitis?

Delayed onset (24–72 hours) after exposure to the allergen (Correct answer)
Immediate burning at the site of contact
Caused by direct tissue damage from the substance
Reaction confined strictly to the area of contact with no spread

Correct answer: Delayed onset (24–72 hours) after exposure to the allergen

Allergic contact dermatitis is a Type IV delayed hypersensitivity reaction that typically appears 24–72 hours after allergen exposure.

Question 79: Where are patch test panels typically applied on the body?

Upper back (Correct answer)
Inner forearm
Abdomen
Behind the ear

Correct answer: Upper back

Patch tests are applied to the upper back because it provides a large, flat surface area with relatively uniform skin for multiple allergen applications.

Question 80: Which process describes the movement of keratinocytes from the stratum basale to the skin surface?

Keratinization (Correct answer)
Mitosis
Cornification
Melanogenesis

Correct answer: Keratinization

Keratinization is the differentiation process by which keratinocytes migrate upward through epidermal layers, accumulating keratin as they travel.

Question 81: Which type of urticaria is caused by physical stimuli such as pressure, cold, or heat?

Dermatographism
Cholinergic urticaria
Physical urticaria (Correct answer)
Allergic urticaria

Correct answer: Physical urticaria

Physical urticaria is triggered by external physical stimuli including cold, heat, pressure, vibration, or exercise.

Question 82: How does risk management apply to daily practice in Patient Education & Counseling for Certified Dermatology Tech professionals?

Through annual safety audits exclusively
By avoiding high-risk situations entirely
Through proactive identification of potential hazards and implementation of preventive measures (Correct answer)
Only through responding to incidents after they occur

Correct answer: Through proactive identification of potential hazards and implementation of preventive measures

Effective risk management in Patient Education & Counseling requires proactive hazard identification and preventive measures, not just reactive responses. This approach reduces incidents, improves outcomes, and protects both professionals and clients.

Question 83: What is the primary reason for using a chalazion clamp during eyelid procedures in dermatology?

To provide hemostasis and stabilize the lesion during removal (Correct answer)
To anesthetize the eyelid tissue
To widen the visual field during dermoscopy
To irrigate the lesion site

Correct answer: To provide hemostasis and stabilize the lesion during removal

A chalazion clamp provides hemostasis by compressing blood vessels and stabilizes the eyelid lesion, facilitating safe removal of the cyst.

Question 84: When instructing a patient to apply a topical medication to the periorbital area, which caution is most critical?

Use twice as much to ensure penetration
Cover with an occlusive dressing
Avoid getting the medication into the eyes (Correct answer)
Apply only at bedtime to avoid light sensitivity

Correct answer: Avoid getting the medication into the eyes

Periorbital application requires extreme caution to prevent medication from contacting the eyes, as many topical agents can cause serious ocular damage.

Question 85: When educating a patient about protective clothing for photoprotection, which UPF rating is considered 'excellent' protection?

UPF 30
UPF 50+ (Correct answer)
UPF 10
UPF 20

Correct answer: UPF 50+

A UPF of 50+ is rated 'excellent' and blocks at least 98% of UV radiation from passing through the fabric.

Question 86: What is keratin?

A connective tissue
A protein providing structure and protection (Correct answer)
A pigment
A hormone

Correct answer: A protein providing structure and protection

Keratin is a tough, fibrous protein that is the primary structural component of the epidermis, hair, and nails. It provides strength, impermeability, and protection against physical damage, water loss, and microbial invasion, forming the skin's protective barrier.

Question 87: Arrector pili muscles attach to hair follicles and are responsible for:

Hair growth rate
Melanin transfer
Sebum secretion
Producing goosebumps (Correct answer)

Correct answer: Producing goosebumps

Contraction of arrector pili smooth muscles causes hair to stand erect, producing goosebumps (cutis anserina) in response to cold or fear.

Question 88: The 'ugly duckling' sign in melanoma screening refers to:

Any lesion larger than 6 mm in diameter
A nevus that is multicolored compared to other nevi
A melanoma arising in an unusual anatomical site
A lesion that looks noticeably different from a patient's other moles (Correct answer)

Correct answer: A lesion that looks noticeably different from a patient's other moles

The 'ugly duckling' concept holds that a melanoma often stands out as morphologically distinct from a patient's other nevi, prompting further evaluation.

Question 89: What is the PRIMARY purpose of continuing education requirements in Skin Cancer Screening & Education for CDT professionals?

Earning additional credentials for career advancement
Maintaining current knowledge and competency as the field evolves (Correct answer)
Networking with other professionals in the field
Fulfilling mandatory regulatory requirements only

Correct answer: Maintaining current knowledge and competency as the field evolves

Continuing education in Skin Cancer Screening & Education ensures professionals maintain current knowledge and skills as standards, technologies, and best practices evolve in the Certified Dermatology Tech field.

Question 90: Lichen planus is classically described by the '6 P's.' Which of the following is NOT one of the 6 P's?

Polygonal
Purple
Pustular (Correct answer)
Pruritic

Correct answer: Pustular

The 6 P's of lichen planus are Pruritic, Purple, Polygonal, Planar, Papules, and Plaques — pustular lesions are not characteristic of lichen planus.

Question 91: When a patient asks about the difference between a benign seborrheic keratosis and a potentially dangerous lesion, the best educational point is:

Seborrheic keratoses have a 'stuck-on,' waxy, warty appearance and are not pre-cancerous (Correct answer)
Seborrheic keratoses always appear before age 30
Any raised brown lesion is a seborrheic keratosis and does not require evaluation
Seborrheic keratoses are caused by UV exposure and require removal

Correct answer: Seborrheic keratoses have a 'stuck-on,' waxy, warty appearance and are not pre-cancerous

Seborrheic keratoses have a characteristic stuck-on, waxy appearance and sharply defined borders; they are benign and not pre-malignant.

Question 92: Which specimen collection method is preferred for diagnosing onychomycosis in a nail?

Clipping from the distal leading edge of affected nail (Correct answer)
Punch biopsy of the nail plate
Shave of the proximal nail fold
Swab of the nail surface

Correct answer: Clipping from the distal leading edge of affected nail

Clippings from the distal leading edge of the affected nail, including subungual debris, yield the highest sensitivity for fungal culture in onychomycosis.

Question 93: A patient undergoing cryotherapy for seborrheic keratoses asks why the lesion will darken before it falls off. Which is the best explanation?

Nitrogen gas trapped in the lesion oxidizes to cause darkening
Cellular destruction causes post-inflammatory discoloration as the lesion crusts and separates (Correct answer)
The liquid nitrogen reacts with melanin to create temporary pigment
The cold stimulates new collagen that pushes the lesion up

Correct answer: Cellular destruction causes post-inflammatory discoloration as the lesion crusts and separates

After cryotherapy, treated cells undergo necrosis and the lesion forms a crust, appearing darker before naturally sloughing off over 1–4 weeks.

Question 94: Phototesting (MED determination) measures the minimum erythema dose. This test is used to:

Determine a patient's UV sensitivity threshold for phototherapy dosing (Correct answer)
Assess skin cancer risk by pigmentation typing
Diagnose fungal scalp infections
Identify allergens causing contact dermatitis

Correct answer: Determine a patient's UV sensitivity threshold for phototherapy dosing

The MED test exposes skin to incremental UV doses to find the lowest dose causing perceptible erythema, guiding safe and effective phototherapy treatment initiation.

Question 95: Which protective measure is mandatory during and after PUVA therapy?

Antibiotic prophylaxis
Full-body sunscreen only
UV-protective goggles during and for 24 hours after treatment (Correct answer)
Topical corticosteroids before each session

Correct answer: UV-protective goggles during and for 24 hours after treatment

UV-protective goggles must be worn during PUVA and for 24 hours after because psoralen sensitizes the eyes to UV-induced damage.

Question 96: Meissner's corpuscles are sensory receptors primarily located in which skin region?

Sebaceous glands
Dermal papillae of hairless skin (Correct answer)
Stratum corneum
Hypodermis

Correct answer: Dermal papillae of hairless skin

Meissner's corpuscles are encapsulated mechanoreceptors found in the dermal papillae of glabrous (hairless) skin, detecting light touch.

Question 97: Which skin function involves heat regulation?

Sensation
Vitamin storage
Immune protection
Thermoregulation (Correct answer)

Correct answer: Thermoregulation

Thermoregulation is the process by which the body maintains its core internal temperature. The skin plays a crucial role in this by regulating blood flow (vasodilation/vasoconstriction) and through sweat production, which cools the body via evaporation.

Question 98: What is considered a standard precaution in infection control?

Asking patients to wear gloves
Using PPE during patient interactions (Correct answer)
Sanitizing once per day
Only washing hands after procedures

Correct answer: Using PPE during patient interactions

Standard precautions are a set of infection control practices used to prevent the transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin, and mucous membranes. Using Personal Protective Equipment (PPE) like gloves, gowns, and masks during patient interactions is a fundamental component of these precautions, protecting both healthcare workers and patients from potential pathogen exposure.

Question 99: A patient refuses a recommended skin biopsy after being fully informed. The tech should:

Contact the patient's family to override the refusal
Proceed with the biopsy citing medical necessity
Document the refusal and respect the patient's decision (Correct answer)
Persuade the patient to reconsider for their own health

Correct answer: Document the refusal and respect the patient's decision

Respecting patient autonomy means honoring an informed refusal; the refusal should be documented and signed if possible.

Question 100: The primary cell type responsible for producing the extracellular matrix of the dermis is the:

Macrophage
Fibroblast (Correct answer)
Endothelial cell
Mast cell

Correct answer: Fibroblast

Fibroblasts synthesize the major components of the dermal extracellular matrix including collagen, elastin, and glycosaminoglycans.

Certified Dermatology Tech (CDT)

The CDT certification, offered by the Association of Certified Dermatology Techs (ACDT), validates the knowledge and skills of dermatology clinical staff across two levels: Level I covering essentials such as skin anatomy, medications, and infection control, and Level II covering advanced topics including skin conditions, lab procedures, and cosmetic dermatology.

100

Questions

90 min

Time Limit

75%

To Pass

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