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The Dermatology exam has 200 questions and runs 4 hours.
These 10 free Dermatology questions are organized by exam domain, so you can see how each part of the Board Certification in Dermatology blueprint is tested. Reveal the answer and explanation under each question.
A dental hygienist develops itchy, fissured eczema over the hands and wrists one to two days after glove-intensive shifts. There are no immediate wheals, respiratory symptoms, or episodes of hypotension. Changing from natural-rubber latex gloves to latex-free nitrile gloves has not resolved the eruption. Which investigation is most useful for identifying a glove-related contact sensitizer?
Correct answer: D - Patch testing with a rubber-accelerator series.
For eight months, a 51-year-old has developed tense blisters on the dorsal hands after minor trauma. Healed lesions leave small scars and milia. There are no oral erosions or systemic features of lupus. Histology shows a subepidermal split. Direct immunofluorescence demonstrates linear basement-membrane IgG, and serum antibodies bind the dermal floor of salt-split skin. Which antigen is the most likely target?
Correct answer: B - Type VII collagen.
An excisional biopsy of a lesion on a 62-year-old man's back shows a 0.6-mm invasive melanoma without ulceration, dermal mitoses, or lymphovascular invasion. The peripheral and deep biopsy margins are clear, and regional lymph nodes are not palpable. Which definitive surgical plan best fits these findings?
Correct answer: C - Excision with a 1-cm clinical margin, without routine sentinel lymph node biopsy.
During Mohs surgery for a recurrent infiltrative basal cell carcinoma of the nasal ala, the first stage shows residual tumor only at the deep margin between 4 and 6 o'clock on the operative map. The peripheral margins and the rest of the deep margin are clear. To obtain clearance while conserving uninvolved tissue, where should the next stage be taken?
Correct answer: D - From the deep plane beneath the mapped 4-to-6-o'clock sector.
A 6-year-old with atopic dermatitis develops fever and rapidly spreading, painful vesicles over the face, neck, and upper trunk. The lesions are strikingly uniform; many have become punched-out erosions, and a few have yellow crusts. Bacterial cultures and a lesional herpes simplex virus PCR have been collected, but results will not be available until tomorrow. What should be started while those results are pending?
Correct answer: A - Systemic acyclovir for suspected eczema herpeticum.
Before treatment for hidradenitis suppurativa, a patient has eight inflammatory nodules, two abscesses, and one draining tunnel. At week 16, there are three inflammatory nodules, one abscess, and two draining tunnels. The patient reports less pain. Does this assessment meet Hidradenitis Suppurativa Clinical Response at the 50% threshold (HiSCR50)?
Correct answer: A - No; new draining tunnels prevent HiSCR50 despite the lower inflammatory lesion count.
A 44-year-old Black woman reports progressive hair loss beginning at the vertex and spreading outward, with intermittent scalp burning. The central scalp is smooth with absent follicular openings. At the expanding edge, several remaining follicles have perifollicular erythema and scale. Looser hairstyles have not stopped progression. The diagnostic priority is to:
Correct answer: A - Obtain a deep punch biopsy from an inflamed edge containing remaining follicles.
At 35 weeks of a first pregnancy, a woman develops intensely pruritic papules within abdominal striae. The papules coalesce into plaques and extend to the buttocks and proximal thighs. The umbilicus is spared. There are no tense blisters, palm or sole symptoms, or primary lesions elsewhere. Which diagnosis provides the best explanation?
Correct answer: A - Polymorphic eruption of pregnancy.
A 9-year-old boy has a tender, boggy scalp plaque with pustules, scaling, and easily extracted broken hairs. There is no discrete fluctuant cavity. Microscopy shows spores within affected hair shafts, and culture grows Trichophyton tonsurans. Which treatment addresses the infection responsible for this presentation?
Correct answer: C - An oral course of terbinafine.
Three weeks after starting oral dapsone for dermatitis herpetiformis, a patient develops exertional dyspnea and a gray-blue discoloration of the lips. Pulse oximetry is 86% on room air, but the arterial oxygen tension is 96 mm Hg. Hemoglobin is essentially unchanged from baseline, the chest examination is clear, and pretreatment G6PD activity was normal. Which test would directly establish the suspected drug complication?
Correct answer: B - Blood co-oximetry.
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