APMLE Dermatology and Nail Disorders 2

Question 1

What is the most appropriate initial treatment for an acute paronychia without abscess formation?

Accepted Answer

Warm soaks and topical antibiotics

Answer

Early acute paronychia without fluctuance responds to warm water soaks and topical antibiotics; incision and drainage are reserved for cases with abscess formation.

Question 2

A subungual hematoma covering less than 25% of the nail plate in a patient with an intact nail and no distal phalanx fracture is best treated by:

Accepted Answer

Trephination (nail decompression)

Answer

Trephination (drilling or heating through the nail plate to drain the hematoma) relieves pain and is appropriate for subungual hematomas regardless of size when the nail is intact.

Question 3

Which clinical feature best differentiates a plantar wart from a corn (heloma durum)?

Accepted Answer

Interruption of normal skin lines (dermatoglyphics)

Answer

Plantar warts interrupt the normal dermal ridge pattern (skin lines), while corns overlie and compress the skin lines, which is the key distinguishing feature.

Question 4

A nevus (mole) located within the nail unit that causes longitudinal melanonychia should be evaluated carefully because it may represent:

Accepted Answer

Acral lentiginous melanoma

Answer

Longitudinal melanonychia with a nail unit nevus raises concern for acral lentiginous melanoma, a serious malignancy disproportionately affecting the nail unit.

Question 5

Which clinical sign (Hutchinson's sign) in nail pigmentation is an indicator of possible subungual melanoma?

Accepted Answer

Periungual pigmentation extending onto the skin of the proximal or lateral nail folds

Answer

Hutchinson's sign refers to pigmentation extending from the nail unit onto the proximal or lateral nail folds, a warning sign associated with subungual melanoma.

APMLE - American Podiatric Medical Licensing Examination Practice Test

APMLE - American Podiatric Medical Licensing Examination Practice Test

APMLE Dermatology and Nail Disorders 2