[HAADDermatology] HAAD Dermatology
DOH Licensureination for Dermatology
Certification Review Guide
**Question 1. Which histopathologic pattern is most characteristic of psoriasis?**
A) Interface dermatitis
B) Psoriasiform hyperplasia
C) Granulomatous inflammation
D) Acantholysis
**Answer: B**
**Explanation:** Psoriasis shows regular elongation of rete ridges (psoriasiform hyperplasia)
with parakeratosis and neutrophils in the stratum corneum.
**Question 2. The primary trigger for allergic contact dermatitis is:**
A) Irritant chemicals
B) Type I IgE‑mediated reaction
C) Type IV delayed hypersensitivity
D) Autoantibodies
**Answer: C**
**Explanation:** Allergic contact dermatitis is a T‑cell mediated (type IV) hypersensitivity
reaction to hapten‑protein complexes.
**Question 3. In atopic dermatitis, the most common colonizing bacterium is:**
A) Staphylococcus aureus
B) Streptococcus pyogenes
C) Pseudomonas aeruginosa
D) Corynebacterium minutissimum
**Answer: A**
, [HAADDermatology] HAAD Dermatology
DOH Licensureination for Dermatology
Certification Review Guide
**Explanation:** Up to 90 % of atopic skin is colonized by S. aureus, contributing to disease
flares.
**Question 4. Which of the following is NOT a typical trigger for chronic urticaria?**
A) Autoimmune antibodies against the IgE receptor
B) Physical pressure (dermographism)
C) Acute viral infection
D) Food additives
**Answer: C**
**Explanation:** Acute viral infections usually cause transient urticaria; chronic urticaria is
more often autoimmune, physical, or related to additives.
**Question 5. The “Nikolsky sign” is positive in all EXCEPT:**
A) Pemphigus vulgaris
B) Toxic epidermal necrolysis
C) Bullous pemphigoid
D) Staphylococcal scalded skin syndrome
**Answer: C**
**Explanation:** Bullous pemphigoid has subepidermal blisters and a negative Nikolsky sign.
**Question 6. The most reliable clinical feature for diagnosing cutaneous lupus erythematosus
is:**
A) Mucosal ulceration
B) Discoid plaques with central atrophy and peripheral hyperpigmentation
, [HAADDermatology] HAAD Dermatology
DOH Licensureination for Dermatology
Certification Review Guide
C) Target lesions
D) Vesicular rash on palms
**Answer: B**
**Explanation:** Discoid lupus classically presents with well‑circumscribed plaques showing
central scarring and peripheral hyperpigmentation.
**Question 7. Which systemic medication is the first‑line oral therapy for severe plaque
psoriasis?**
A) Acitretin
B) Methotrexate
C) Cyclosporine
D) Apremilast
**Answer: B**
**Explanation:** Methotrexate is the conventional first‑line systemic agent for severe psoriasis
due to efficacy and cost.
**Question 8. In the ABCDE rule for melanoma, “E” stands for:**
A) Elevation
B) Erythema
C) Enlargement over time
D) Evolution of the lesion
**Answer: D**
**Explanation:** “E” emphasizes any change in size, shape, color, or symptoms, indicating
evolution.
, [HAADDermatology] HAAD Dermatology
DOH Licensureination for Dermatology
Certification Review Guide
**Question 9. Breslow thickness measures:**
A) Horizontal tumor diameter
B) Depth of invasion in millimeters from the granular layer
C) Depth of invasion in millimeters from the epidermal surface
D) Number of mitoses per high‑power field
**Answer: C**
**Explanation:** Breslow thickness is the vertical depth of melanoma measured from the
granular layer (or epidermal surface) to the deepest tumor cell.
**Question 10. The recommended surgical margin for a low‑risk basal cell carcinoma <2 cm
is:**
A) 1 mm
B) 4 mm
C) 10 mm
D) 15 mm
**Answer: B**
**Explanation:** Low‑risk BCCs are adequately excised with a 4 mm peripheral margin.
**Question 11. Which of the following is a hallmark of squamous cell carcinoma on
histology?**
A> Basaloid nests with peripheral palisading
B> Acantholysis and tombstone cells
C> Keratin “pearls” and intercellular bridges
D> Spongiosis and eosinophils
DOH Licensureination for Dermatology
Certification Review Guide
**Question 1. Which histopathologic pattern is most characteristic of psoriasis?**
A) Interface dermatitis
B) Psoriasiform hyperplasia
C) Granulomatous inflammation
D) Acantholysis
**Answer: B**
**Explanation:** Psoriasis shows regular elongation of rete ridges (psoriasiform hyperplasia)
with parakeratosis and neutrophils in the stratum corneum.
**Question 2. The primary trigger for allergic contact dermatitis is:**
A) Irritant chemicals
B) Type I IgE‑mediated reaction
C) Type IV delayed hypersensitivity
D) Autoantibodies
**Answer: C**
**Explanation:** Allergic contact dermatitis is a T‑cell mediated (type IV) hypersensitivity
reaction to hapten‑protein complexes.
**Question 3. In atopic dermatitis, the most common colonizing bacterium is:**
A) Staphylococcus aureus
B) Streptococcus pyogenes
C) Pseudomonas aeruginosa
D) Corynebacterium minutissimum
**Answer: A**
, [HAADDermatology] HAAD Dermatology
DOH Licensureination for Dermatology
Certification Review Guide
**Explanation:** Up to 90 % of atopic skin is colonized by S. aureus, contributing to disease
flares.
**Question 4. Which of the following is NOT a typical trigger for chronic urticaria?**
A) Autoimmune antibodies against the IgE receptor
B) Physical pressure (dermographism)
C) Acute viral infection
D) Food additives
**Answer: C**
**Explanation:** Acute viral infections usually cause transient urticaria; chronic urticaria is
more often autoimmune, physical, or related to additives.
**Question 5. The “Nikolsky sign” is positive in all EXCEPT:**
A) Pemphigus vulgaris
B) Toxic epidermal necrolysis
C) Bullous pemphigoid
D) Staphylococcal scalded skin syndrome
**Answer: C**
**Explanation:** Bullous pemphigoid has subepidermal blisters and a negative Nikolsky sign.
**Question 6. The most reliable clinical feature for diagnosing cutaneous lupus erythematosus
is:**
A) Mucosal ulceration
B) Discoid plaques with central atrophy and peripheral hyperpigmentation
, [HAADDermatology] HAAD Dermatology
DOH Licensureination for Dermatology
Certification Review Guide
C) Target lesions
D) Vesicular rash on palms
**Answer: B**
**Explanation:** Discoid lupus classically presents with well‑circumscribed plaques showing
central scarring and peripheral hyperpigmentation.
**Question 7. Which systemic medication is the first‑line oral therapy for severe plaque
psoriasis?**
A) Acitretin
B) Methotrexate
C) Cyclosporine
D) Apremilast
**Answer: B**
**Explanation:** Methotrexate is the conventional first‑line systemic agent for severe psoriasis
due to efficacy and cost.
**Question 8. In the ABCDE rule for melanoma, “E” stands for:**
A) Elevation
B) Erythema
C) Enlargement over time
D) Evolution of the lesion
**Answer: D**
**Explanation:** “E” emphasizes any change in size, shape, color, or symptoms, indicating
evolution.
, [HAADDermatology] HAAD Dermatology
DOH Licensureination for Dermatology
Certification Review Guide
**Question 9. Breslow thickness measures:**
A) Horizontal tumor diameter
B) Depth of invasion in millimeters from the granular layer
C) Depth of invasion in millimeters from the epidermal surface
D) Number of mitoses per high‑power field
**Answer: C**
**Explanation:** Breslow thickness is the vertical depth of melanoma measured from the
granular layer (or epidermal surface) to the deepest tumor cell.
**Question 10. The recommended surgical margin for a low‑risk basal cell carcinoma <2 cm
is:**
A) 1 mm
B) 4 mm
C) 10 mm
D) 15 mm
**Answer: B**
**Explanation:** Low‑risk BCCs are adequately excised with a 4 mm peripheral margin.
**Question 11. Which of the following is a hallmark of squamous cell carcinoma on
histology?**
A> Basaloid nests with peripheral palisading
B> Acantholysis and tombstone cells
C> Keratin “pearls” and intercellular bridges
D> Spongiosis and eosinophils
