SPEX Dermatology 1 — Questions and Answers
Question 1: What is the first-line treatment for mild to moderate atopic dermatitis in adults?
- Systemic corticosteroids
- Topical corticosteroids (Correct answer)
- Oral antihistamines
- Phototherapy
Correct answer: Topical corticosteroids
Topical corticosteroids are the first-line treatment for mild to moderate atopic dermatitis, directly reducing skin inflammation and pruritus.
Question 2: Which skin cancer has the highest mortality rate despite representing a smaller percentage of all skin cancer cases?
- Basal cell carcinoma
- Squamous cell carcinoma
- Melanoma (Correct answer)
- Merkel cell carcinoma
Correct answer: Melanoma
Melanoma accounts for the majority of skin cancer deaths due to its high metastatic potential, despite being less common than basal cell and squamous cell carcinomas.
Question 3: The characteristic rash of Lyme disease, erythema migrans, is best described as which pattern?
- Bull's-eye (target) pattern expanding from bite site (Correct answer)
- Vesicular eruption along a dermatome
- Petechial rash on trunk and extremities
- Malar butterfly rash sparing nasolabial folds
Correct answer: Bull's-eye (target) pattern expanding from bite site
Erythema migrans presents as a bull's-eye or target pattern that expands outward from the tick bite site, representing the hallmark early sign of Lyme disease.
Question 4: Which oral medication for severe acne vulgaris reduces sebum production but is highly teratogenic, requiring the iPLEDGE program?
- Doxycycline
- Isotretinoin (Correct answer)
- Spironolactone
- Clindamycin
Correct answer: Isotretinoin
Isotretinoin (Accutane) is a vitamin A derivative that reduces sebum production by shrinking sebaceous glands and is teratogenic, requiring monthly pregnancy tests under the iPLEDGE program.
Question 5: Which histological finding is considered the hallmark of psoriasis?
- Regular acanthosis with elongated rete ridges and parakeratosis (Correct answer)
- Spongiosis with eosinophilic infiltrate
- Subepidermal blistering with linear IgG deposits
- Caseating granulomas in the dermis
Correct answer: Regular acanthosis with elongated rete ridges and parakeratosis
Psoriasis is characterized histologically by regular acanthosis, elongation of rete ridges, parakeratosis, and Munro microabscesses due to keratinocyte hyperproliferation.
Question 6: Which diagnostic test is considered the gold standard for identifying allergic contact dermatitis?
- Skin prick test
- Serum IgE levels
- Patch testing (Correct answer)
- Intradermal testing
Correct answer: Patch testing
Patch testing is the gold standard for diagnosing allergic contact dermatitis, exposing the skin to potential allergens under occlusion for 48 hours to identify specific triggers.
Question 7: A Tzanck smear showing multinucleated giant cells is diagnostic of which infection?
- Impetigo caused by Staphylococcus aureus
- Herpes simplex or varicella-zoster virus infection (Correct answer)
- Pemphigus vulgaris
- Molluscum contagiosum
Correct answer: Herpes simplex or varicella-zoster virus infection
A Tzanck smear showing multinucleated giant cells (Tzanck cells) indicates herpes simplex or varicella-zoster virus infection, though it cannot distinguish between the two.
SPEX Dermatology 1
What is the first-line treatment for mild to moderate atopic dermatitis in adults?