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These 10 free Pediatric Dermatology questions are organized by exam domain, so you can see how each part of the Pediatric Dermatology blueprint is tested. Reveal the answer and explanation under each question.
At a two-month visit, six discrete infantile hemangiomas are found on an infant's trunk and extremities. Each is less than 1 cm across; none is ulcerated or segmental. The infant feeds well, has a normal heart rate, and has no hepatomegaly. What screening study is indicated despite the reassuring examination?
Correct answer: C - Abdominal ultrasonography to screen for hepatic hemangiomas
Five days of cephalexin have not improved a six-year-old's tender, boggy scalp plaque. Examination shows patchy alopecia, broken hairs, follicular pustules, and posterior cervical lymphadenopathy. The child is afebrile and otherwise well. Potassium hydroxide examination of plucked hairs is negative, and fungal culture is pending. The next intervention should be:
Correct answer: B - Begin oral griseofulvin without routinely incising or draining the plaque
After 16 weeks of treatment, an 11-year-old's Eczema Area and Severity Index (EASI) has fallen from 36 to 8. The current Patient-Oriented Eczema Measure (POEM) score is 21, and itching still disrupts sleep on most nights. How should these outcomes be interpreted together?
Correct answer: A - EASI-75 response with severe residual patient-reported symptoms
Despite four months of adherent doxycycline, benzoyl peroxide, and topical tretinoin, a 16-year-old boy continues to develop deep facial and truncal acne nodules and new atrophic scars. He has no ulcerative lesions or systemic symptoms. He and his parents are ready to consider another systemic treatment. The most appropriate change is to:
Correct answer: C - Discontinue doxycycline and initiate isotretinoin with the required counseling and monitoring
An urgent consultation is requested for a three-year-old with atopic dermatitis, fever of 39.1°C, and rapidly spreading painful erosions. Most erosions are round and similar in size; several have hemorrhagic crust. The child is lethargic and refusing fluids. A bacterial swab obtained the previous day has grown methicillin-susceptible Staphylococcus aureus. Alongside admission and hydration, which initial anti-infective strategy is appropriate?
Correct answer: D - Begin intravenous acyclovir while sending lesion material for HSV PCR
"He is still scratching. Does he need a stronger medicine?" asks the parent of a seven-year-old treated for scabies. Permethrin was correctly applied twice, one week apart; the second application was seven days ago. All household contacts were treated simultaneously and bedding was laundered. At yesterday's examination, the old papules were flattening and there were no new lesions or burrows. The child remains well. Which telephone advice is appropriate?
Correct answer: B - Use topical hydrocortisone for residual dermatitis; monitor for new burrows
The community nursery requests advice about a term newborn examined six hours after birth. Superficial pustules without surrounding erythema are present on the chin, trunk, palms, and soles. Several lesions have already become brown macules with a fine collarette of scale. The infant is alert, feeding normally, and has normal vital signs. A pustule smear shows predominantly neutrophils and no organisms. What disposition fits this presentation?
Correct answer: A - Observe in the nursery and explain that the pigmentation will fade
Recalcitrant molluscum contagiosum and recurrent extensive herpes simplex eruptions complicate an eight-year-old's severe eczema. His history includes recurrent pneumonias, asthma, and immediate reactions to several foods. Testing shows marked IgE elevation and eosinophilia, but normal platelet number and size. Dental and skeletal examinations are unremarkable. Taken together, these findings most strongly suggest:
Correct answer: A - DOCK8 deficiency
Biopsy is performed in a nine-month-old whose crusted scalp and diaper-area eruption has persisted despite appropriate antifungal and anti-inflammatory treatment. Scattered petechial papules are present, although the platelet count is normal. Histology shows an infiltrate of cells with grooved nuclei admixed with eosinophils. Which immunophenotype would support the suspected diagnosis?
Correct answer: C - CD1a and CD207 (langerin) positivity
Seven café-au-lait macules measuring 8-12 mm and bilateral axillary freckling are noted in a four-year-old. There are no neurofibromas, characteristic osseous lesions, or known affected parent. Ophthalmologic assessment is normal. Before counseling the family, the clinician reviews the 2021 revised neurofibromatosis type 1 criteria. Which statement accurately captures the diagnostic uncertainty?
Correct answer: D - Two NF1 criteria are met, but the findings do not exclude Legius syndrome
The Pediatric Dermatology exam also covers these domains. Drill them in the full free practice test:
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