FMCLA Dermatology 1 — Questions and Answers
Question 1: A 17-year-old male presents with mild acne vulgaris consisting primarily of comedones with few papules. Which topical agent is considered first-line monotherapy?
- Topical clindamycin
- Topical tretinoin (retinoid) (Correct answer)
- Topical benzoyl peroxide
- Topical dapsone
Correct answer: Topical tretinoin (retinoid)
Topical retinoids are first-line for comedonal acne because they normalize follicular keratinization and prevent microcomedo formation.
Question 2: A 35-year-old presents with well-demarcated, erythematous plaques with silvery scales on the elbows and knees. The most likely diagnosis is:
- Lichen planus
- Psoriasis vulgaris (Correct answer)
- Nummular eczema
- Pityriasis rosea
Correct answer: Psoriasis vulgaris
Psoriasis vulgaris classically presents with well-demarcated erythematous plaques covered with silvery-white scales on extensor surfaces such as elbows and knees.
Question 3: A 2-year-old presents with pruritic, erythematous, weeping patches on the cheeks and extensor surfaces. Family history is positive for asthma and hay fever. The most likely diagnosis is:
- Seborrheic dermatitis
- Contact dermatitis
- Atopic dermatitis (Correct answer)
- Psoriasis
Correct answer: Atopic dermatitis
Atopic dermatitis presents in infants on the cheeks and extensor surfaces with a personal or family history of atopy (asthma, allergic rhinitis, eczema) — the atopic triad.
Question 4: Which feature of a pigmented skin lesion is MOST concerning for malignant melanoma?
- Symmetric shape with uniform tan color
- Diameter less than 3 mm
- Irregular border with multiple colors (tan, brown, black) (Correct answer)
- A smooth, raised papule with well-defined margins
Correct answer: Irregular border with multiple colors (tan, brown, black)
Irregular borders and multiple colors are hallmark ABCDE criteria for melanoma, reflecting uncontrolled, asymmetric tumor cell proliferation.
Question 5: A patient develops a pruritic, erythematous vesicular rash on the wrists after wearing a new metal watch. The most likely diagnosis is:
- Atopic dermatitis
- Allergic contact dermatitis (Correct answer)
- Irritant contact dermatitis
- Nummular eczema
Correct answer: Allergic contact dermatitis
Allergic contact dermatitis from nickel (common in metal watches) is a Type IV hypersensitivity reaction presenting with pruritic vesicular rash confined to the contact area.
Question 6: A 22-year-old presents with scaling, pruritic patches in the groin. KOH preparation reveals hyphae. The most appropriate treatment is:
- Topical corticosteroid alone
- Oral acyclovir
- Topical antifungal such as clotrimazole (Correct answer)
- Topical antibacterial cream
Correct answer: Topical antifungal such as clotrimazole
Tinea cruris is a dermatophyte infection confirmed by KOH prep showing hyphae; topical antifungals such as clotrimazole are first-line treatment.
Question 7: A 45-year-old woman presents with persistent facial erythema, flushing, and papulopustules on the cheeks and nose. She reports triggers including alcohol and spicy foods. The most likely diagnosis is:
- Acne vulgaris
- Systemic lupus erythematosus
- Rosacea (Correct answer)
- Seborrheic dermatitis
Correct answer: Rosacea
Rosacea presents with centrofacial erythema, flushing, and papulopustules without comedones, commonly triggered by alcohol, spicy foods, heat, and sun exposure.
FMCLA Dermatology 1
A 17-year-old male presents with mild acne vulgaris consisting primarily of comedones with few papules.
Which topical agent is considered first-line monotherapy?