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Dermatology Flashcards

7 cards from real PANCE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 60-year-old man presents with a brown-black lesion with asymmetry, irregular border, color variegation, and diameter of 7 mm on his back. Biopsy confirms melanoma with Breslow thickness of 1.2 mm. What is the recommended surgical margin?

    Answer: 1 cm margin

    For melanoma with Breslow thickness 1.01–2.0 mm, a 1 cm surgical margin is recommended per NCCN guidelines.

  2. A 35-year-old woman develops erythematous papules and pustules on her central face, persistent flushing with alcohol or spicy food, and telangiectasias. She has no comedones. What is the diagnosis?

    Answer: Rosacea

    Rosacea presents with central facial erythema, flushing triggers, telangiectasias, and inflammatory papulopustules but notably lacks comedones.

  3. A 28-year-old man presents with scaly, hypopigmented macules on his trunk that become more prominent after sun exposure. KOH preparation shows 'spaghetti and meatballs' hyphae. What organism is responsible?

    Answer: Malassezia furfur

    Tinea versicolor is caused by Malassezia furfur, a lipophilic yeast that produces the classic 'spaghetti and meatballs' pattern on KOH prep.

  4. A 5-year-old child presents with fever, malaise, and diffuse flaccid bullae with superficial skin sloughing that resembles scalded skin. Nikolsky sign is positive. What is the causative organism?

    Answer: Staphylococcus aureus exfoliative toxin

    Staphylococcal scalded skin syndrome is caused by exfoliative toxins A and B from S. aureus that cleave desmoglein-1, causing superficial skin separation.

  5. A 50-year-old woman presents with Wickham striae on the buccal mucosa and violaceous, flat-topped papules on the flexor wrists. The lesions are intensely pruritic. What is the first-line treatment?

    Answer: High-potency topical corticosteroids

    Lichen planus is treated first-line with high-potency topical corticosteroids for cutaneous lesions; mucosal disease may require intralesional or systemic steroids.

  6. A 22-year-old woman presents with painful genital ulcers, tender inguinal lymphadenopathy, and dysuria. PCR confirms HSV-2 primary infection. What treatment reduces future recurrence frequency?

    Answer: Daily oral valacyclovir suppressive therapy

    Daily suppressive therapy with valacyclovir (or acyclovir) reduces HSV-2 recurrences by approximately 70–80% and decreases viral shedding.

  7. A 75-year-old man has a rough, scaly, erythematous papule on a sun-damaged area of his face. Biopsy shows atypical keratinocytes confined to the epidermis. What is the diagnosis?

    Answer: Bowen disease

    Bowen disease (SCC in situ) shows full-thickness epidermal atypia without dermal invasion, distinguishing it from invasive SCC; it is treated with topical 5-FU, PDT, or excision.