PANCE, Medical exams, 4%

Dermatologic System

Dermatology rewards precise lesion vocabulary and pattern recognition across inflammatory, infectious, and neoplastic skin disease. Descriptions substitute for photographs, so translating morphology words into diagnoses is the core skill.

Position: 14 of 15 content areas
Published weighting: 4% in the official framework
Topics covered: 6 topics in this guide

What is covered

Topics inside this content area.

These topics describe the scope students most often review for this part of PANCE. Treat them as a study checklist rather than an exhaustive list of what a single exam form can sample.

Eczematous and papulosquamous disease: Atopic dermatitis, contact dermatitis, psoriasis, and lichen planus patterns.
Skin infections and infestations: Bacterial, viral, fungal, and parasitic presentations with first-line therapy.
Acneiform and follicular disorders: Acne severity staging, rosacea, and hidradenitis basics.
Skin neoplasms: Melanoma warning criteria and the classic looks of basal cell and squamous cell carcinoma.
Drug eruptions and severe cutaneous reactions: Morbilliform rashes through SJS/TEN with their triggers and urgency.
Burns, bites, and environmental injury: Burn depth and surface-area estimation plus bite-wound care rules.

Study tips

How to practice Dermatologic.

Section-specific guidance that follows from how this material is usually tested.

Memorize primary-lesion vocabulary first; every stem is written in that language.
Use image flashcards for neoplasm look-alikes and rate yourself honestly.
Keep the severe drug-reaction red flags on one card you review often.

Where this fits

Dermatologic System is 14 of 15 content areas in the PANCE guide, and it carries a published weighting of 4% in the official framework. Use the full guide to balance it against everything else you have to review.

Back to the PANCE guide Official exam information

Sample Dermatologic questions

Practice questions, not yet expert-reviewed

Original practice questions written to the published framework for this section. No expert has reviewed them, and they are not taken from any official exam. Try each one before you open the answer.

Question 1Foundational
Which skin cancer should be suspected in a pigmented lesion that is asymmetric with irregular borders, several colors, a diameter greater than 6 mm, and recent change?
1. AMelanoma
2. BBasal cell carcinoma
3. CSquamous cell carcinoma
4. DSeborrheic keratosis
Show answer
Answer: A. Melanoma
Asymmetry, border irregularity, color variegation, diameter over 6 mm, and evolution are the classic warning features of melanoma and mandate biopsy. Seborrheic keratosis is the tempting distractor because it is pigmented and common, but it is a sharply demarcated, waxy, stuck-on plaque that does not evolve in this way.
Key insight: Change over time is the single most important warning feature of a pigmented lesion.
Question 2Foundational
Which skin cancer classically appears on sun-exposed skin as a slowly growing pearly papule with rolled borders, surface telangiectasias, and central ulceration?
1. ASquamous cell carcinoma
2. BBasal cell carcinoma
3. CAmelanotic melanoma
4. DActinic keratosis
Show answer
Answer: B. Basal cell carcinoma
Basal cell carcinoma is the most common skin cancer and presents as a translucent pearly papule with telangiectasias that may ulcerate centrally, growing locally but almost never metastasizing. Squamous cell carcinoma is the tempting distractor because it also arises on sun-damaged skin, but it is typically a firm, scaly, hyperkeratotic or crusted nodule and it carries real metastatic potential.
Key insight: Pearly and telangiectatic is basal cell; scaly, keratotic, and tender is squamous cell.
Question 3Intermediate
Which chronic skin disease produces sharply demarcated erythematous plaques with thick silvery scale on the elbows, knees, and scalp, with pinpoint bleeding when the scale is lifted?
1. AAtopic dermatitis
2. BPlaque psoriasis
3. CLichen planus
4. DTinea corporis
Show answer
Answer: B. Plaque psoriasis
Psoriasis favors extensor surfaces and the scalp, and removing its silvery scale exposes dilated dermal capillaries that bleed in pinpoints, the Auspitz sign. Atopic dermatitis is the tempting distractor because it is also chronic and itchy, but it favors flexural surfaces and produces ill-defined, weepy, lichenified patches without silvery scale.
Key insight: Extensor and silvery means psoriasis; flexural and poorly defined means atopic dermatitis.
Question 4Intermediate
Which severe cutaneous adverse reaction is defined by painful epidermal detachment involving more than 30 percent of the body surface area with mucosal involvement?
1. AStevens-Johnson syndrome
2. BToxic epidermal necrolysis
3. CDrug reaction with eosinophilia and systemic symptoms
4. DErythema multiforme minor
Show answer
Answer: B. Toxic epidermal necrolysis
The two ends of the same spectrum are separated by body surface area, and detachment above 30 percent defines toxic epidermal necrolysis, which carries the higher mortality and needs burn-level supportive care. Stevens-Johnson syndrome is the tempting distractor, but it is limited to less than 10 percent detachment, with 10 to 30 percent labeled overlap.
Key insight: Under 10 percent is Stevens-Johnson syndrome, over 30 percent is toxic epidermal necrolysis, and the space between is overlap.
Question 5Advanced
Using the rule of nines in an adult, what percentage of total body surface area is burned when the entire anterior trunk and one entire arm are involved?
1. A18 percent
2. B22.5 percent
3. C27 percent
4. D36 percent
Show answer
Answer: C. 27 percent
In the adult rule of nines the anterior trunk counts as 18 percent and an entire arm, front and back, counts as 9 percent, giving 27 percent in total. Answering 18 percent is the tempting error of counting only the trunk, and 36 percent double counts by treating the whole trunk rather than only its anterior surface.
Key insight: Adult rule of nines: 9 percent per arm and head, 18 percent per leg and per trunk surface, and 1 percent for the perineum.

Continue through PANCE

Practice Dermatologic deliberately.

Create your Arcade Academy workspace to turn this topic list into spaced-repetition reviews, linked notes, and progress you can act on.

Create your account

Dermatologic System