Derma Channel (OSCE slides, lectures, MCQs and discussion)
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Channel Posts
A 27-year-old woman with no significant past medical history presents with a focal patch of hair loss on the frontal scalp that developed over the past month. She denies pain, pruritus, or other associated symptoms. She reports no preceding illness, recent hairstyling trauma, or new medications. Family history is notable for a mother with type 1 diabetes mellitus
On physical examination, there is a single, well-circumscribed, round patch of nonscarring alopecia on the frontal scalp as attached picture . The skin within the patch is smooth, without erythema, scale, or scarring. The remainder of the scalp and other hair-bearing areas are unaffected.
What is the most likely diagnosis?
A- Tinea capitis
B- Alopecia areata
C- Trichotillomania
D- Telogen effluvium
| 2 |  A 10-day-old full-term infant is brought to the clinic for evaluation of several firm, mobile, subcutaneous nodules on the cheeks, shoulders, and back. The infant was otherwise healthy at birth. which of the following systemic findings is most classically associated with this condition and can occur months later?
A. Hyperkalemia and hypoglycemia.
B. Thrombocytopenia , hypertriglyceridemia and hypercalcemia .
C. Hyperthermia .
D. Birth truma . | 160 |
| 3 |  A 45-year-old patient presents with painful, red, ulcerating nodules on the lower trunk and proximal extremities that drain an oily material. A biopsy reveals liquefactive necrosis of the dermis and subcutaneous septa. The patient has a strong family history of similar skin lesions, and genetic testing confirms an autosomal co-dominant inheritance pattern. Which of the following is the most likely underlying diagnosis?
A) Erythema Nodosum
B) Alpha-1 Antitrypsin Deficiency Panniculitis
C) Weber-Christian Disease
D) Pancreatic Panniculitis | 154 |
| 4 |  A child presents to the clinic with photosensitivity without significant pigmentary changes, associated with features of premature aging and cachectic dwarfism. No other significant abnormalities are noted.
What is the most likely diagnosis?
A. Xeroderma pigmentosum.
B. Bloom syndrome.
C. Progeria.
D. Cockayne syndrome. | 302 |
| 5 |  32-year-old woman with a history of systemic lupus erythematosus (SLE) and hidradenitis suppurativa presented for evaluation of a new tongue finding noticed over the past month. She denied tongue pain, dysphagia, bleeding, recent trauma, or other oral lesions. Review of systems was otherwise unremarkable.
Physical examination revealed bilateral, symmetric, regularly spaced indentations along the lateral margins of the tongue corresponding to the adjacent dentition. The tongue was moist and of normal color without ulcerations, plaques, nodules, depapillated patches, or focal masses. The remainder of the oral examination was unremarkable.
What is the most likely diagnosis?
A- Geographic tongue
B- Oral lichen planus
C- Median rhomboid glossitis
D- Scalloped (crenated) tongue | 362 |
| 6 |  An adult male, as shown in the attached figures, presents with erythematous to reddish-brown papulonodules involving the mucous membranes, periungual areas, and elbows. The skin lesions preceded the onset of destructive arthritis. He has no known chronic medical conditions and no history of medication use.
What is the most likely diagnosis?
A. Dermatomyositis
B. Multicentric reticulohistiocytosis
C. Rheumatoid arthritis
D. Adult-onset Still’s disease | 319 |
| 7 |  An adult male presents to a dentist with gingival hypertrophy, erosions, and bleeding. On examination, he has follicular hyperkeratosis, corkscrew hairs, perifollicular hemorrhages, petechiae, and ecchymoses. He also reports fatigue, weight loss, and diarrhea. Investigations reveal anemia and an increased susceptibility to infections. He has no history of diabetes mellitus or hypertension.
What is the most likely diagnosis?
A. Cyclosporine-induced gingival hyperplasia
B. Gingivitis
C. Scurvy (vitamin C deficiency)
D. Dental abscess | 330 |
| 8 |  A child presents with symmetrical clusters of multiple follicular papules with central keratotic plugs, xerosis, and Bitot’s spots.
What is the most likely diagnosis?
A. Vitamin A deficiency.
B. Atopic dermatitis with keratosis pilaris.
C. Plane warts.
D. Molluscum contagiosum. | 304 |
| 9 |  An adult with fair skin presents with dome-shaped, translucent to yellowish papules on chronically sun-exposed areas. The lesions may become nodular or pigmented following the application of topical hydroquinone.
What is the most likely diagnosis?
A. Lipoid proteinosis
B. Colloid milium
C. Primary systemic amyloidosis
D. Gout
E- Erythropoietic protoporphyria. | 350 |
| 10 |  A patient presents with marked macroglossia, periorbital waxy papules, and eyelid lesions, as shown in the attached images.
What is the most likely diagnosis?
A - Primary localized cutaneous amyloidosis .
B- Systemic localized cutaneous amyloidosis.
C- AA amyloidosis secondary to chronic inflammation .
D- Hereditary transthyretin amyloidosis . | 366 |
| 11 |  A 60-year-old woman presents with a longstanding dystrophic right great toenail, present for several years. She has previously attempted treatment with over-the-counter topical antifungal creams without adequate response. The nail is asymptomatic, without associated pain, bleeding, or drainage
On physical examination, the right hallux nail plate demonstrates yellow-brown discoloration, opacification, and loss of normal luster with marked nail plate thickening consistent with hyperkeratosis and noted subungual debris (Figure). Hypertrophy of the lateral nail folds and hyponychium is present with distal nail embedding. A hallux valgus deformity is also appreciated. There is no ulceration or bleeding.
What is the most likely diagnosis?
A- Nail psoriasis
B- Nail lichen planus
C- Onychomycosis
D- Traumatic onychodystrophy | 482 |
| 12 |  +1A 56-year-old woman presents with redness, itching, and a "rough and bumpy" sensation in her left nipple and areola, with occasional oozing of yellow pus. Physical examination reveals an erythematous, scaly, and crusted plaque on the nipple (as seen in the image). A punch biopsy of the skin shows large, pale cells with abundant clear cytoplasm within the epidermis, as indicated by the yellow arrows (as seen in the histology image).
What is the most likely diagnosis?
A) Nipple dermatitis (Eczema)
B) Paget's disease of the nipple
C) Squamous cell carcinoma of the nipple
D) Malignant melanoma of the nipple
E) Cutaneous T-cell lymphoma | 521 |
| 13 |  No text... | 564 |
| 14 |  No text... | 592 |
| 15 |  A 53-year-old man with no significant past medical history presents to the dermatology clinic with an enlarging mass on his left ventral arm superior to the antecubital fossa. It has been present for approximately 7 months. On examination, the lesion is firm and mobile, with a linear scar noted on the inferior aspect of the lesion. The lesion felt deep to the muscle, so an ultrasound was ordered.
The ultrasound report describes an ill-defined hypoechoic area with ill-defined borders in the subcutaneous tissue superficial to the biceps muscle measuring 2.2 x 0.8 x 2.5 cm. A biopsy of the mass is performed. The patient reports receiving a biceps tendon repair at the same site 4 years prior. An excision was performed at the time.
What is the most likely diagnosis?
A- Lipoma
B- Plexiform fibrohistiocytic tumor
C- Liposarcoma
D- Granulomatous suture reaction | 605 |
| 16 |  +3An otherwise healthy 48-year-old female presented to our clinic with a 3-month history of pruritic scaly brown patches and plaques in the left axilla The patient had been self-treating the lesions with 1% hydrocortisone cream and bacitracin, with no improvement. A biopsy was performed for histopathology (Figs 5 and 6).
1.
What is the most likely diagnosis?
a.Acanthosis nigricans
b.Confluent and reticulated papillomatosis
c.Darier's disease
d.Axillary granular parakeratosis
e.Erythasma
2.
This condition most likely develops from which of the following?
a.Defect in the processing of profilaggrin to filaggrin
b.Excessive use of topical preparations
c.Local occlusion
d.Irritation from increased sweating
e.All of the above | 702 |
| 17 |  A 63-year-old male presented with a crusted, nonhealing ulcer on his right lower lip measuring approximately 1 cm × 1 cm in diameter. The lesion had been present for about 6 months and had slowly increased in size during that time (Fig 2).
1.The differential diagnosis includes all the following except:
a.superficial basal cell carcinoma (BCC)
b.hypertrophic actinic keratosis (AK)
c.keratoacanthoma (KA)
d.squamous cell carcinoma (SCC)
e.seborrheic keratosis
A deep shave biopsy was performed that showed atypical squamous cells and a build-up of excess keratin. The papule was excised using Mohs micrographic surgery.
2.The most likely diagnosis is:
a.superficial BCC
b.hypertrophic AK
c.KA
d.SCC
e.seborrheic keratosis | 412 |
| 18 |  A 27-year-old African American woman presented with a 5-month history of erythematous, erosive lesions with fissuring under both axillae and on the chest (Fig 1). The lesions were painful, pruritic, and worsened with heat and moisture. The patient had applied topical Neosporin (Johnson & Johnson, Titusville, NJ), which did not improve her skin problem. The patient did not take any other medications. The patient had no significant past medical history, but her family history included a similar skin problem affecting her mother and maternal uncle. On physical examination, confluent erosions on an erythematous base with crusting and fissuring were noted under both axillae.
The most likely diagnosis is:
a.allergic contact dermatitis
b.Candidal intertrigo
c.Hailey–Hailey disease
d.pemphigus vegetans
e.inverse psoriasis | 440 |
| 19 |  Which of the following findings is most commonly associated with Lamellar Ichthyosis as described in the text?
A) Large, brown, plate-like scales with significant associated erythema
B) A "self-healing" phenotype where the skin becomes normal after membrane resolution
C) Large, brown, plate-like scales with little or no associated erythema
D) Involvement limited exclusively to the trunk and scalp in all patients. | 492 |
| 20 |  A patient with thick, spiny, hyperkeratotic skin lesions is shown. What is the most likely diagnosis?
A. Ichthyosis vulgaris
B. Ichthyosis hystrix
C. Epidermolysis bullosa
D. Darier disease | 390 |
