COMSAE Dermatology and Integumentary System 2

Question 1

A 40-year-old woman presents with facial flushing, erythema across the nose and cheeks, telangiectasias, and papulopustules. She reports flares with sun exposure, hot beverages, and alcohol. Which diagnosis is most likely?

Accepted Answer

Rosacea

Answer

Rosacea is characterized by central facial erythema, flushing, telangiectasias, and papulopustules triggered by heat, alcohol, spicy food, and UV exposure.

Question 2

A 50-year-old presents with greasy, yellowish scales on the scalp, nasolabial folds, and eyebrows. Which organism is implicated in the pathogenesis of seborrheic dermatitis?

Accepted Answer

Malassezia furfur

Answer

Malassezia furfur (a lipophilic yeast) colonizes sebaceous areas and triggers an inflammatory response causing seborrheic dermatitis.

Question 3

A 70-year-old farmer presents with an indurated, erythematous nodule on the lower lip that ulcerates and does not heal. Biopsy shows malignant squamous cells with keratin pearls. Which risk factor is most strongly associated with this diagnosis?

Accepted Answer

Chronic UV radiation exposure

Answer

Squamous cell carcinoma of the lip and skin is most strongly associated with chronic UV radiation exposure, particularly in fair-skinned, outdoor workers.

Question 4

A 28-year-old develops widespread pruritic wheals of various sizes that resolve within 24 hours without leaving bruising or scarring. She denies systemic symptoms. Which mechanism is responsible?

Accepted Answer

IgE-mediated mast cell degranulation releasing histamine

Answer

Urticaria is caused by IgE-mediated mast cell degranulation releasing histamine and other mediators, causing transient wheals that resolve without trace.

Question 5

A 19-year-old started trimethoprim-sulfamethoxazole for a urinary tract infection. Three weeks later she develops widespread erythematous targetoid lesions involving mucosal surfaces, with epidermal detachment >30% of the body surface area. Which condition best describes this presentation?

Accepted Answer

Toxic epidermal necrolysis (TEN)

Answer

Toxic epidermal necrolysis (TEN) is a severe drug reaction with epidermal detachment >30% BSA and mucosal involvement, most commonly triggered by sulfonamides and anticonvulsants.

COMSAE - Comprehensive Osteopathic Medical Self-Assessment Examination Practice Test

COMSAE - Comprehensive Osteopathic Medical Self-Assessment Examination Practice Test

COMSAE Dermatology and Integumentary System 2