COMSAE Dermatology and Integumentary System

Question 1

A 16-year-old presents with open and closed comedones, papules, and pustules on the face. Which mechanism is most responsible for the pathogenesis of acne vulgaris?

Accepted Answer

Follicular plugging with keratin and sebum combined with Cutibacterium acnes proliferation

Answer

Autoimmune destruction of sebaceous glands

Answer

Staphylococcus aureus superficial skin infection

Answer

IgE-mediated mast cell degranulation in the dermis

Question 2

A 45-year-old presents with well-demarcated, erythematous plaques with silvery-white scales on the elbows and scalp. Auspitz sign is positive. Which finding on histopathology is most characteristic of this condition?

Accepted Answer

Parakeratosis with neutrophils in the stratum corneum (Munro microabscesses)

Answer

Spongiosis with eosinophilic infiltrate

Answer

Acantholysis with suprabasal blistering

Answer

Hyperkeratosis with melanin incontinence

Question 3

Which of the following ABCDE features of a pigmented skin lesion is MOST associated with early melanoma detection?

Accepted Answer

Asymmetry — one half does not match the other

Answer

A uniform tan color throughout the lesion

Answer

Border that is well-defined and regular

Answer

Diameter less than 6 mm

Question 4

A 32-year-old factory worker develops pruritic vesicles and erythema on both hands after starting a new job using epoxy resins. Patch testing shows a reaction to epoxy resin. What type of hypersensitivity reaction is this?

Accepted Answer

Type IV (delayed-type/cell-mediated)

Answer

Type I (IgE-mediated)

Answer

Type II (cytotoxic)

Answer

Type III (immune complex-mediated)

Question 5

A 22-year-old athlete presents with scaling, itching, and erythema between the toes with maceration. KOH preparation shows branching hyphae. Which organism is most likely responsible?

Accepted Answer

Trichophyton rubrum

Answer

Candida albicans

Answer

Malassezia furfur

Answer

Microsporum canis

Question 6

A 6-year-old with a family history of asthma and allergic rhinitis presents with intensely pruritic, erythematous, lichenified patches in the antecubital and popliteal fossae. Which immunological finding is most commonly elevated in this condition?

Accepted Answer

IgE

Answer

IgA

Answer

IgG

Answer

IgM

Question 7

A 65-year-old with a history of heavy sun exposure presents with a pearly, translucent nodule with rolled borders and telangiectasias on the nose. Which is the most likely diagnosis?

Accepted Answer

Basal cell carcinoma

Answer

Squamous cell carcinoma

Answer

Melanoma

Answer

Keratoacanthoma