PANRE Dermatology 3

Question 1

A 45-year-old with HIV (CD4 count 80) presents with verrucous, cauliflower-like plaques on the trunk unresponsive to topical antifungals. Biopsy shows intracytoplasmic inclusion bodies (Henderson-Paterson bodies). What is the diagnosis?

Accepted Answer

Molluscum contagiosum

Answer

Molluscum contagiosum in severely immunocompromised patients (CD4 <200) can present atypically as large, widespread plaques; Henderson-Paterson bodies are pathognomonic on biopsy.

Question 2

A neonate develops a desquamating rash starting around the mouth and spreading to form large flaccid bullae that rupture to leave a scalded appearance. Nikolsky sign is positive. Which toxin is responsible?

Accepted Answer

Staphylococcal exfoliative toxin A/B

Answer

Staphylococcal scalded skin syndrome is caused by exfoliative toxins A and B from S. aureus, which cleave desmoglein-1 in the superficial epidermis.

Question 3

A 60-year-old woman with rheumatoid arthritis on methotrexate develops painless, white, lacy streaks on the buccal mucosa and violaceous, polygonal, flat-topped papules on the wrists. What is the most likely diagnosis?

Accepted Answer

Lichen planus

Answer

Lichen planus classically presents with the 6 P's: pruritic, polygonal, planar, purple papules and plaques, often with Wickham's striae on mucosal surfaces.

Question 4

A 35-year-old woman notes symmetric hyperpigmented patches on her cheeks and upper lip that worsen during summer and pregnancy. She is on oral contraceptives. What is the recommended first-line treatment?

Accepted Answer

Topical hydroquinone 4% + sun protection

Answer

Hydroquinone 4% combined with strict photoprotection is first-line for melasma; the triple combination (hydroquinone + tretinoin + mild corticosteroid) is more effective for resistant cases.

Question 5

Which dermoscopic finding is most specific for melanoma?

Accepted Answer

Atypical pigment network with regression

Answer

An atypical pigment network with irregular meshwork combined with regression structures (white scar-like areas, blue-gray peppering) is highly specific for melanoma on dermoscopy.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Dermatology 3