A 16-year-old presents with non-inflammatory open and closed comedones on the forehead and nose without papules, pustules, or nodules. Which first-line topical agent specifically targets comedogenesis?
Derm Inflammatory
Question · Easy
A 22-year-old woman with severe nodulocystic acne is starting isotretinoin. Which is required by the iPLEDGE REMS program before each monthly refill in a patient of childbearing potential?
Question · Medium
A 28-year-old woman has persistent jawline acne flaring premenstrually. Labs are normal. Which oral therapy targets the androgen-driven mechanism?
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Which combination of topical agents reduces antibiotic resistance when treating inflammatory acne?
A 45-year-old woman has central facial flushing, telangiectasias, and burning triggered by hot drinks and sunlight, but no papules or pustules. Which rosacea subtype is this?
A 50-year-old man has papulopustular rosacea. Which oral agent provides anti-inflammatory benefit at a sub-antimicrobial dose?
A 60-year-old man has progressive nasal enlargement with thickened, bulbous skin and patulous follicles. Which rosacea subtype and definitive treatment apply?
Question · Hard
A 4-year-old has pruritic, ill-defined erythematous patches with lichenification in antecubital and popliteal fossae. Family history is positive for asthma. What is the diagnosis?
Which topical corticosteroid is in class I (super-potent) and should not be used on the face or in skin folds?
A 6-year-old with atopic dermatitis on the face has not responded to low-potency steroids. Which steroid-sparing topical is appropriate?
A 30-year-old with severe atopic dermatitis refractory to topicals and phototherapy is started on dupilumab. What is its mechanism?
Which oral JAK inhibitors are approved for moderate-to-severe atopic dermatitis?
A 35-year-old presents with well-demarcated erythematous plaques covered by silvery scale on the elbows and knees. Auspitz sign is positive. What is the diagnosis?
A 19-year-old develops sudden small drop-like erythematous scaly papules on the trunk two weeks after streptococcal pharyngitis. Which psoriasis variant is this?
Which topical adjunct to corticosteroids is a vitamin D3 analog that normalizes keratinocyte differentiation in psoriasis?
A 45-year-old with severe plaque psoriasis (BSA 25%, PASI 18) has failed methotrexate. Which biologic class targets IL-23 and provides long dosing intervals (every 8-12 weeks)?
Which oral small-molecule phosphodiesterase-4 inhibitor is approved for plaque psoriasis and psoriatic arthritis without lab monitoring?
A psoriasis patient on infliximab develops weight loss, night sweats, and a productive cough. Which screening should have been performed before initiating any TNF-alpha inhibitor?
A 30-year-old with moist erythematous patches in the axillae, inguinal folds, and inframammary area without scale has which psoriasis variant?
Which phototherapy modality is first-line in-office treatment for moderate plaque psoriasis?
A 6-year-old has honey-colored crusted erosions on the perioral area. The most likely organisms include which pathogen?
Derm Infections
A 60-year-old with poorly controlled diabetes presents with a sharply demarcated, raised, bright red, painful plaque on the left cheek. Which diagnosis and treatment apply?
A 25-year-old has a fluctuant, tender 4-cm abscess on the buttock. Which is the cornerstone of treatment?
A 35-year-old has grouped vesicles on an erythematous base on the lower lip with prodromal tingling. Which oral antiviral provides effective treatment?
A 70-year-old has a unilateral painful vesicular eruption in the T5 dermatome. Beyond antivirals, which adjunct reduces postherpetic neuralgia?
A 4-year-old has multiple small dome-shaped pearly papules with central umbilication. Which is the diagnosis?
A 30-year-old has rough hyperkeratotic papules on the fingers with thrombosed capillaries (black dots) seen on paring. What is the diagnosis and a first-line treatment?
A 25-year-old has an annular scaling plaque with central clearing on the thigh. KOH prep shows septate hyphae. What is the diagnosis and treatment for limited disease?
A 7-year-old African American boy has scaly patches on the scalp with broken-off hairs ('black dots') and posterior cervical lymphadenopathy. Which therapy is required?
A 40-year-old has intense generalized pruritus worse at night with burrows in the finger webs and wrists. The patient's spouse also itches. What is first-line treatment?
A 65-year-old has a chronic ulcer on the lower extremity with surrounding erythema and a draining sinus. Cultures grow MRSA. Which oral antibiotic provides MRSA coverage with good tissue penetration?
A 30-year-old has hypopigmented finely scaling patches on the upper back and chest. KOH shows 'spaghetti and meatballs' (short hyphae and round yeast). What is the diagnosis?
Which onychomycosis treatment is most effective for confirmed dermatophyte toenail infection?
A 28-year-old man has tender, fluctuant nodules and draining sinus tracts in both axillae and groin with scarring. What is the diagnosis?
A 50-year-old diabetic presents with rapidly spreading erythema, severe pain out of proportion to exam, crepitus, and gray bullae on the leg. What is the next step?
A 70-year-old has a pearly translucent papule with telangiectasias and a rolled border on the nose. What is the most likely diagnosis?
Derm Neoplastic
Which BCC subtype has poorly defined borders, often with a scar-like appearance, and the highest recurrence rate after standard excision?
What are the standard surgical margins for low-risk primary BCC?
A 65-year-old farmer has a rough sandpaper-like erythematous papule on the dorsal hand. Which lesion does this represent?
A 75-year-old has an indurated, ulcerated 2.5-cm nodule on the lip. Biopsy shows invasive SCC. Which treatment is preferred?
A 60-year-old has a scaly, well-demarcated erythematous patch on the lower leg present for years. Biopsy shows full-thickness keratinocyte atypia confined to the epidermis. What is the diagnosis?
What is the recommended margin for excision of cutaneous SCC <2 cm?
What does the 'E' in the ABCDE criteria for melanoma stand for?
A 50-year-old has an asymmetric pigmented lesion biopsied showing melanoma with Breslow depth 1.2 mm without ulceration. What is the recommended next step regarding nodal staging?
What are the recommended wide local excision margins for a melanoma with Breslow depth 1.5 mm?
A patient with metastatic melanoma is found to have a BRAF V600E mutation. Which targeted therapy combination is appropriate?
An 80-year-old has a rapidly growing red-violaceous nodule on the sun-exposed temple. Biopsy shows small round blue cells with neuroendocrine markers (CK20 dot pattern). Diagnosis?
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