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DNPCB-DCNP : DNPCB Dermatology Certified Nurse Practitioner Exam
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DNPCB Dermatology Certified Nurse Practitioner
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Question: 1
A 35-year-old woman presents with a sudden onset of painful, grouped vesicles on an erythematous base, affecting the left side of her face. She also reports a prodromal phase of burning and tingling sensation in the same area. What is the most likely diagnosis?
erpes simplex virus infection mpetigo
rysipelas wer: A
anation: The patient's clinical presentation is consistent with herpes z gles), a viral infection caused by the reactivation of the varicella-zost Herpes zoster typically presents as painful, grouped vesicles on an ematous base, following a dermatomal distribution. The prodromal p urning and tingling sensation is characteristic of herpes zoster. Herpes lex virus infection typically presents as grouped vesicles on an ematous base, but it is not typically dermatomal. Impetigo presents w y-colored crusts and vesicles, commonly affecting the face. Erysipela erial infection characterized by well-demarcated, raised, erythematous ues with a shiny appearance.
stion: 2
Herpes zoster (shingles) H I E Ans Expl oster (shin er virus. eryth hase of b simp eryth ith hone s is a bact plaq A 35-year-old female presents with a pruritic rash on her hands. She works as a hairdresser and has been exposed to various chemicals and frequent wet work. On examination, you observe erythematous, scaly, and fissured patches on the dorsal surfaces of her hands and fingers. There are no vesicles or bullae. Which of the following conditions is most likely to be associated with this presentation? Allergic contact dermatitis Dyshidrotic eczema Irritant contact dermatitis anation: The presentation described is consistent with irritant contact atitis. Irritant contact dermatitis occurs as a result of repeated exposur ting substances, such as chemicals or frequent wet work. It is characte ythematous, scaly, and fissured patches on the affected areas. Allergi act dermatitis, on the other hand, is a delayed hypersensitivity reaction fic allergen and often presents with vesicles or bullae. Dyshidrotic ec ally presents with vesicles or bullae on the palms, soles, or lateral asp fingers. Tinea manuum, or fungal infection of the hand, may present ematous, scaly patches, but it is less likely in the absence of vesicles o e and a history of exposure to potential fungal sources. -year-old female presents with erythematous, scaly plaques on her sc nd her ears, and in her retroauricular regions. She complains of itching sional hair loss. On examination, you observe silvery-white scales an ive Auspitz sign. Which of the following is the most likely diagnosis? Expl derm e to irrita rized by er c cont to a speci zema typic ects of the with eryth r bulla A 30 alp, behi and occa d a posit Psoriasis Seborrheic dermatitis Tinea capitis Contact dermatitis Answer: A al infection of the scalp, may present with scaling and hair loss, but it ikely to have the characteristic silvery-white scales seen in psoriasis. act dermatitis typically occurs in areas of exposure to allergens or irrit ay present with erythema, edema, and vesicles. -year-old male patient presents with a pruritic rash on his elbows, kne calp. On examination, you observe well-demarcated, erythematous ues with silvery scales. The patient reports that his father also has a si ondition. What is the most likely diagnosis? soriasis topic dermatitis tyriasis rosea inea corporis wer: A less l Cont ants and m A 25 es, and s plaq milar skin c P A Pi T Ans Explanation: The clinical presentation described is consistent with psoriasis, a chronic autoimmune skin condition. Psoriasis commonly presents as well- demarcated, erythematous plaques with silver-white scales. It typically affects the extensor surfaces of the elbows and knees, as well as the scalp. Psoriasis has a genetic component and can run in families. Atopic dermatitis (eczema) typically presents with pruritic, erythematous patches and papules in flexural areas. Pityriasis rosea presents with oval-shaped, erythematous plaques with a collarette of scale, often following a "herald patch." Tinea corporis (ringworm) presents with circular, erythematous patches with raised borders and central clearing. mination, you observe erythematous papules, vesicles, and scaling invo ateral aspects of her fingers and the web spaces. She works as a nurse uently washes her hands. Which of the following is the most likely nosis? llergic contact dermatitis yshidrotic eczema ritant contact dermatitis cabies infestation wer: B anation: The clinical presentation described is consistent with dyshidr ma, also known as pompholyx. Dyshidrotic eczema is a type of eczem atitis characterized by pruritic, erythematous papules, vesicles, and sc e lateral aspects of the fingers and in the web spaces. It iscommonly ciated with frequent hand washing and exposure to irritants. Allergic act dermatitis may present with a similar appearance but is usually A 35-year-old female presents with a pruritic rash on her hands and fingers. On exa lving the l and freq diag A D Ir S Ans Expl otic ecze atous derm aling on th asso cont localized to the areas of contact with the allergen. Irritant contact dermatitis can also present with similar findings but is typically more diffuse and involves areas exposed to irritants. Scabies infestation usually presents with burrows, papules, and excoriations in interdigital spaces, wrists, and other areas where mites burrow. yoderma gangrenosum rterial insufficiency ulcer iabetic foot ulcer enous stasis ulcer wer: D anation: The clinical presentation described is highly suggestive of a us stasis ulcer. Venous stasis ulcers typically occur in the lower leg, cularly around the medial or lateral malleolus, in patients with chronic us insufficiency. They have a punched-out appearance with undermin and a necrotic base. The surrounding skin may exhibit signs of veno ficiency, such as edema, hyperpigmentation, and venous stasis dermat erma gangrenosum is a rare ulcerative condition characterized by pai ulcers with undermined violaceous edges. Arterial insufficiency ulcers are lly located on the lower extremities and are associated with peripheral disease. Diabetic foot ulcers are common in patients with diabetes a occur at pressure points on the foot. A 65-year-old male presents with a non-healing ulcer on his lower leg. The ulcer has a punched-out appearance with undermined edges and a necrotic base. The surrounding skin shows signs of chronic venous insufficiency, including edema, hyperpigmentation, and venous stasis dermatitis. Which of the following is the most likely diagnosis? P A D V Ans Expl veno parti veno ed edges us insuf itis. Pyod nful usua artery nd often A 40-year-old man presents with multiple hyperpigmented macules on his face. He reports that the lesions have been present since childhood and have remained stable in size and shape. On examination, you observe well- demarcated, light-brown macules distributed symmetrically on the cheeks, Lentigines Melasma Cafe-au-lait macules anation: The clinical presentation described is consistent with lentigin h are benign, well-demarcated, light-brown macules that commonly a un-exposed areas. Lentigines usually emerge during childhood or earl hood and remain stable in size and shape. Melasma presents as rpigmented patches on the face, often associated with sun exposure an monal changes. Cafe-au-lait macules are light-brown macules that may ent at birth or develop in childhood, but they are typically larger and h ular borders. Post-inflammatory hyperpigmentation occurs following mmation or injury to the skin, resulting in localized areas of increased entation. -year-old man presents with a solitary, pigmented lesion on his back. mination, you observe a macule with an irregular border, variegated co symmetric shape. The lesion measures 8 mm in diameter. What is the appropriate initial management? Expl es, whic ppear on s y adult hype d hor be pres ave irreg infla pigm A 65 On exa lors, and a most Excisional biopsy Shave biopsy Observation with serial monitoring Cryotherapy -year-old woman presents with an intensely pruritic rash on her wrists es. On examination, you observe linear burrows, vesicles, and excoriat ese areas. What is the most likely diagnosis? cabies ontact dermatitis rythema multiforme emphigus vulgaris wer: A anation: The clinical presentation described is consistent with scabies, sitic infestation caused by the Sarcoptes scabiei mite. Scabies presents sely pruritic linear burrows, vesicles, and excoriations, commonly ting the wrists, hands, and interdigital spaces. Contact dermatitis may A 50 and ankl ions in th S C E P Ans Expl a para with inten affec present with a rash in exposed areas, but it does not typically have the characteristic burrows seen in scabies. Erythema multiforme presents with target-like lesions with central dusky erythema and surrounding rings. Pemphigus vulgaris is an autoimmune blistering disorder characterized by flaccid bullae and erosions on the skin and mucous membranes. cne vulgaris osacea eborrheic dermatitis erioral dermatitis wer: B anation: Rosacea is a chronic inflammatory skin condition that primar ts the central face. The clinical presentation typically includes erythe les, pustules, and telangiectasias. In contrast to acne vulgaris, rosacea nvolve the nasolabial folds or periocular area. Seborrheic dermatitis ally presents with erythematous plaques with greasy scales, commonl ting the scalp, face, and central chest. Perioral dermatitis is characteri ythematous papules and pustules around the mouth, sparing the vermi er. A R S P Ans Expl ily affec ma, papu does not i typic y affec zed by er llion bord A 30-year-old male patient presents to your clinic with a pruritic rash on his hands. He works as a florist and frequently handles flowers and plants. On examination, you observe erythematous, vesicular lesions on the dorsal aspects of his hands and fingers. The lesions are arranged in a linear pattern. Which of the following is the most likely diagnosis? Contact dermatitis Scabies Dyshidrotic eczema anation: The patient's occupation as a florist and the presence of a pru n the hands suggest contact dermatitis, which is an inflammatory ski ition caused by exposure to irritants or allergens. The linear arrangem vesicular lesions is consistent with a contact allergen. Scabies prese urrows, papules, and vesicles in interdigital spaces, wrists, axillae, a Dyshidrotic eczema typically presents with pruritic vesicles on the s, lateral fingers, and soles. Herpes simplex virus infection commonly ents as grouped vesicles on an erythematous base, typically affecting t ocutaneous junctions. -year-old male presents with a pruritic rash on the extensor surfaces o ws and knees. The rash consists of well-demarcated erythematous pla ilvery scales. On examination, you also notice pitting and ridging of Which of the following conditions is most likely to be associated wit resentation? Expl ritic rash o n cond ent of the nts with b nd groin. palm pres he muc A 45 f his elbo ques with s his nails. h this p Psoriasis Atopic dermatitis Contact dermatitis Seborrheic dermatitis Answer: A itant. Seborrheic dermatitis typically affects areas with high sebaceou activity, such as the scalp, face, and central chest, and is characteriz ematous plaques with greasy scales. -year-old male presents with a non-healing ulcer on his lower leg. Th is irregularly shaped with a necrotic base and surrounding erythema. rts a history of peripheral artery disease and intermittent claudication. ch of the following is the most likely underlying cause of this ulcer? enous stasis ulcer rterial insufficiency ulcer iabetic foot ulcer ressure ulcer wer: B gland ed by eryth A 55 e ulcer He repo Whi V A D P Ans Explanation: The clinical presentation described is consistent with an arterial insufficiency ulcer. Arterial insufficiency ulcers typically occur in patients with peripheral artery disease and are often located on the lower extremities, especially the lower leg and foot. These ulcers are irregularly shaped, have a necrotic base, and are associated with surrounding erythema. Patients may also report symptoms of peripheral artery disease, such as intermittent claudication. Venous stasis ulcers, on the other hand, are typically located around the medial or lateral malleolus and are associated with edema and hemosiderin deposition. Diabetic foot ulcers are common in patients with diabetes and are often located on pressure points of the foot. Pressure ulcers result from prolonged pressure on bony prominences and are commonly seen in immobile or bedridden patients. le on her nose. On examination, you observe a translucent, pearly pap rominent telangiectasias. There is a central depression and rolled, rai ers. What is the most likely diagnosis? asal cell carcinoma quamous cell carcinoma elanoma eborrheic keratosis wer: A anation: The clinical presentation described is highly suggestive of ba arcinoma (BCC), the most common type of skin cancer. BCC typical ents as a pearly papule or nodule with telangiectasias. It often has a ce ession and rolled, raised borders. Squamous cell carcinoma (SCC) ma ent as a scaly, erythematous plaque or a rapidly growing, tender nodul noma is characterized by an asymmetric mole with irregular borders, tion, and a diameter larger than 6 mm. Seborrheic keratosis are benig A 55-year-old woman presents with a gradually enlarging, painless, pinkish nodu ule with p sed bord B S M S Ans Expl sal cell c ly pres ntral depr y pres e. Mela color varia n lesions that present as sharply demarcated, waxy, stuck-on plaques with a "stuck-on" appearance. A 28-year-old female presents with a facial rash consisting of papules, pustules, and comedones. She reports a worsening of symptoms in response to sunlight exposure. On examination, you note erythematous papules and pustules on her cheeks and nose, with some areas of comedonal acne. She does not have a history of flushing or telangiectasias. Which of the following is the most likely diagnosis? Acne vulgaris Acne rosacea erioral dermatitis wer: B anation: The presentation described is consistent with acne rosacea. A cea is a chronic inflammatory skin condition that primarily affects the al face, including the cheeks, nose, chin, and forehead. It is characteri ythematous papules, pustules,and sometimes comedones. Unlike acne aris, acne rosacea is typically not associated with significant involvem trunk or back. One distinguishing feature is the worsening of sympt sponse to sunlight exposure. Flushing and telangiectasias may also be ent in rosacea, but they are not mentioned in the question stem. Acne aris, on the other hand, typically presents with comedones, papules, an ules on the face, chest, and back. Seborrheic dermatitis commonly affe reas of the skin, such as the scalp, face, and central chest, and is acterized by erythematous plaques with greasy scales. Perioral dermati ents as erythematous papules and pustules around the mouth, sparing t illion border. P Ans Expl cne rosa centr zed by er vulg ent of the oms in re pres vulg d pust cts oily a char tis pres he verm A 55-year-old male presents with a new growth on his nose. On examination, you observe a pearly, translucent papule with telangiectasias and a rolled, elevated border. There is no pain or bleeding associated with the lesion. Which of the following is the most likely diagnosis? Basal cell carcinoma Squamous cell carcinoma Malignant melanoma anation: The clinical presentation described is consistent with basal ce noma (BCC). BCC is the most common type of skin cancer and often rs in sun-exposed areas, such as the face. It typically presents as a pea lucent papule with telangiectasias (tiny blood vessels) and a rolled, ated border. BCC is usually painless and does not bleed easily. Squam arcinoma may also occur on the nose but is more commonly associat a crusted, scaly plaque or nodule. Malignant melanoma often presents ymmetric, pigmented lesion with irregular borders. Actinic keratosis i ancerous lesion that appears as a rough, scaly patch and is not typicall y or translucent. Expl ll carci occu rly, trans elev ous cell c ed with as an as s a prec y pearl
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