Dermatology PANCE 2025| Actual Exam
Questions and Correct Answers
Question 1: A patient presents with a rash characterized by red macules and edematous papules
with a clearing center. This best describes:
A) Erythema marginatum
B) Erythema multiforme
C) Varicella
D) Impetigo
Correct Answer: B) Erythema multiforme
Explanation: Erythema multiforme is characterized by target (iris) lesions with red macules,
edematous papules, and central clearing, often resolving in 3–6 weeks.
Question 2: In a patient suspected of having seborrheic dermatitis, the most common site of
involvement would be:
A) Upper extremities
B) Thighs
C) Scalp
D) Feet
Correct Answer: C) Scalp
Explanation: Seborrheic dermatitis commonly affects the scalp (e.g., dandruff), eyebrows,
nasolabial folds, and ears due to sebaceous gland activity.
Question 3: A 26-year-old male with intense itching, especially at night, and red
papules/excoriations on volar wrists, finger webs, and waist. Proper diagnosis includes:
A) KOH prep
B) Gram stain
C) Skin scraping microscopy
D) Tzanck prep
,Correct Answer: C) Skin scraping microscopy
Explanation: Scabies is diagnosed by microscopy of skin scrapings showing mites, eggs, or
feces, confirming the infestation.
Question 4: A 35-year-old female with fatigue, fever, and a 6 cm annular lesion with red border
and clear center on her mid-back. Laboratory test to support diagnosis:
A) KOH prep of skin scrapings
B) Blood cultures
C) RAST testing
D) Serologic antibody testing
Correct Answer: D) Serologic antibody testing
Explanation: The annular lesion (erythema migrans) suggests Lyme disease; serologic testing
(e.g., ELISA, Western blot) supports diagnosis after a few weeks.
Question 5: A 56-year-old carpenter with a nontender 6 mm macular lesion under the left
thumbnail, mixed brown/black with irregular borders. Most likely diagnosis:
A) Lentigo
B) Trauma
C) Melanoma
D) Nevus
Correct Answer: C) Melanoma
Explanation: A pigmented lesion with irregular borders and variegated colors under the nail bed
suggests acral lentiginous melanoma, requiring biopsy.
Question 6: A 2-year-old with 3-day history of cough, rhinorrhea, conjunctivitis, fever (103°F),
and white papules on buccal mucosa. Most consistent with:
A) Rubeola
B) Rubella
C) Varicella
D) Streptococcal pharyngitis
, Correct Answer: A) Rubeola
Explanation: Rubeola (measles) presents with cough, coryza, conjunctivitis, fever, and Koplik
spots (white papules on buccal mucosa), pathognomonic for measles.
Question 7: A person with atopic dermatitis should be advised to:
A) Avoid cutaneous irritants
B) Take hot water baths or showers
C) Use a high potency glucocorticoid on skin after bathing
D) Begin a prophylactic antibiotic
Correct Answer: A) Avoid cutaneous irritants
Explanation: Avoiding irritants (e.g., wool, harsh soaps) is key to managing atopic dermatitis,
preventing exacerbations.
Question 8: Elderly woman with unilateral facial pain, vesicles on an erythematous base in a
dermatomal pattern, and blurred vision. Next intervention:
A) KOH prep
B) Culture for bacteria
C) Referral to an ophthalmologist
D) Application of corticosteroids
Correct Answer: C) Referral to an ophthalmologist
Explanation: Herpes zoster involving the maxillary region and nose tip (Hutchinson’s sign) with
blurred vision suggests possible herpes keratitis, requiring urgent ophthalmology referral.
Question 9: A 28-year-old female with diabetes and an 18% TBSA partial thickness burn to arm
and chest. Most appropriate treatment:
A) Outpatient application of silver sulfadiazine
B) Debridement of all intact blisters
C) IV cefazolin
D) Transfer to a burn center
Correct Answer: D) Transfer to a burn center
Questions and Correct Answers
Question 1: A patient presents with a rash characterized by red macules and edematous papules
with a clearing center. This best describes:
A) Erythema marginatum
B) Erythema multiforme
C) Varicella
D) Impetigo
Correct Answer: B) Erythema multiforme
Explanation: Erythema multiforme is characterized by target (iris) lesions with red macules,
edematous papules, and central clearing, often resolving in 3–6 weeks.
Question 2: In a patient suspected of having seborrheic dermatitis, the most common site of
involvement would be:
A) Upper extremities
B) Thighs
C) Scalp
D) Feet
Correct Answer: C) Scalp
Explanation: Seborrheic dermatitis commonly affects the scalp (e.g., dandruff), eyebrows,
nasolabial folds, and ears due to sebaceous gland activity.
Question 3: A 26-year-old male with intense itching, especially at night, and red
papules/excoriations on volar wrists, finger webs, and waist. Proper diagnosis includes:
A) KOH prep
B) Gram stain
C) Skin scraping microscopy
D) Tzanck prep
,Correct Answer: C) Skin scraping microscopy
Explanation: Scabies is diagnosed by microscopy of skin scrapings showing mites, eggs, or
feces, confirming the infestation.
Question 4: A 35-year-old female with fatigue, fever, and a 6 cm annular lesion with red border
and clear center on her mid-back. Laboratory test to support diagnosis:
A) KOH prep of skin scrapings
B) Blood cultures
C) RAST testing
D) Serologic antibody testing
Correct Answer: D) Serologic antibody testing
Explanation: The annular lesion (erythema migrans) suggests Lyme disease; serologic testing
(e.g., ELISA, Western blot) supports diagnosis after a few weeks.
Question 5: A 56-year-old carpenter with a nontender 6 mm macular lesion under the left
thumbnail, mixed brown/black with irregular borders. Most likely diagnosis:
A) Lentigo
B) Trauma
C) Melanoma
D) Nevus
Correct Answer: C) Melanoma
Explanation: A pigmented lesion with irregular borders and variegated colors under the nail bed
suggests acral lentiginous melanoma, requiring biopsy.
Question 6: A 2-year-old with 3-day history of cough, rhinorrhea, conjunctivitis, fever (103°F),
and white papules on buccal mucosa. Most consistent with:
A) Rubeola
B) Rubella
C) Varicella
D) Streptococcal pharyngitis
, Correct Answer: A) Rubeola
Explanation: Rubeola (measles) presents with cough, coryza, conjunctivitis, fever, and Koplik
spots (white papules on buccal mucosa), pathognomonic for measles.
Question 7: A person with atopic dermatitis should be advised to:
A) Avoid cutaneous irritants
B) Take hot water baths or showers
C) Use a high potency glucocorticoid on skin after bathing
D) Begin a prophylactic antibiotic
Correct Answer: A) Avoid cutaneous irritants
Explanation: Avoiding irritants (e.g., wool, harsh soaps) is key to managing atopic dermatitis,
preventing exacerbations.
Question 8: Elderly woman with unilateral facial pain, vesicles on an erythematous base in a
dermatomal pattern, and blurred vision. Next intervention:
A) KOH prep
B) Culture for bacteria
C) Referral to an ophthalmologist
D) Application of corticosteroids
Correct Answer: C) Referral to an ophthalmologist
Explanation: Herpes zoster involving the maxillary region and nose tip (Hutchinson’s sign) with
blurred vision suggests possible herpes keratitis, requiring urgent ophthalmology referral.
Question 9: A 28-year-old female with diabetes and an 18% TBSA partial thickness burn to arm
and chest. Most appropriate treatment:
A) Outpatient application of silver sulfadiazine
B) Debridement of all intact blisters
C) IV cefazolin
D) Transfer to a burn center
Correct Answer: D) Transfer to a burn center
