Dermatology Exam Review: Diagnosis & Common Skin Disorders for Physician Assistants

Prepare for your physician assistant certification exam with this detailed review of dermatologic disorders from A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants by Claire Babcock O'Connell and Thea Cogan-Drew. This summary highlights key diagnostic techniques, clinical features, and management strategies for common skin diseases including eczematous, papulosquamous, vesiculobullous, papulopustular disorders, infections, tumors, ulcers, burns, hair, and nail conditions.

Watch the podcast summary above and subscribe to Last Minute Lecture for more clinical insights and PA exam preparation.

Diagnostic Approach in Dermatology

• History & Physical Exam: Consider medical history, medications, psychosocial, and environmental exposures. Use MAD criteria (Morphology, Arrangement, Distribution) to describe lesions.
• Special Signs: Darier sign (urticarial flare), Auspitz sign (pinpoint bleeding in psoriasis), Nikolsky sign (dermal separation in pemphigus).
• Diagnostic Techniques: Diascopy, KOH prep, Wood's lamp, and biopsy.

Eczematous Disorders

• Contact Dermatitis: Irritant and allergic types; avoid irritants and use topical steroids.
• Atopic Dermatitis: Chronic relapsing dermatitis with history of atopy; managed with antihistamines, steroids, emollients.
• Seborrheic & Nummular Dermatitis: Managed with topical steroids, antifungals, and phototherapy if severe.

Papulosquamous & Plaque Disorders

• Lichen Simplex Chronicus: Chronic itching, treated by breaking itch-scratch cycle.
• Psoriasis: Chronic inflammatory disease with silvery scales and nail involvement; treated with steroids, vitamin D analogs, phototherapy.
• Pityriasis Rosea & Lichen Planus: Self-limited; symptomatic treatment.

Vesiculobullous Disorders

• Pemphigus Vulgaris & Bullous Pemphigoid: Autoimmune blistering diseases; treated with systemic steroids and immunosuppressants.

Papulopustular & Inflammatory Disorders

• Acne Vulgaris & Rosacea: Managed with topical/oral antibiotics and isotretinoin for severe cases.
• Folliculitis & Erythema Multiforme: Bacterial infections and hypersensitivity reactions; treated with antibiotics and trigger avoidance.
• Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis: Life-threatening mucocutaneous reactions requiring emergency care.

Localized Infections & Infestations

• Furuncles, Carbuncles, Cellulitis: Managed with antibiotics, warm compresses, surgical drainage when necessary.
• Scabies, Lice, Spider Bites: Treated with topical pediculicides and supportive care.

Tumors & Skin Neoplasms

• Benign Neoplasms: Keratoses, lipomas, pyogenic granulomas.
• Malignant Neoplasms: Melanoma, squamous cell carcinoma, basal cell carcinoma; treated with excision, cryotherapy, systemic therapy if needed.

Ulcers, Burns & Wounds

• Ulcers: Diabetic, stasis, arterial, pressure ulcers; managed with wound care and treating underlying causes.
• Burns & Wounds: Require debridement, dressings, and infection control.

Hair, Nail & Pigmentation Disorders

• Alopecia, Onychomycosis, Vitiligo: Managed with topical and systemic treatments tailored to each condition.

Glossary of Key Terms

• Auspitz Sign: Pinpoint bleeding seen in psoriasis.
• Nikolsky Sign: Diagnostic sign in blistering disorders.
• Koebner Phenomenon: New lesions at trauma sites.
• Lichenification: Thickened skin from chronic rubbing.
• Telangiectasia: Dilated superficial blood vessels, often seen in rosacea.
• Hyperkeratosis: Thickening of the skin’s outer layer.

Conclusion: Key Takeaways for Dermatology Exam Prep

Mastery of common dermatologic disorders, diagnostic techniques, and treatments is essential for physician assistants preparing for certification exams. Focus on clinical presentations, high-yield signs, and evidence-based management to excel.

For a detailed review, watch the podcast summary and visit Last Minute Lecture for more high-yield PA exam resources.

If you found this guide helpful, subscribe to Last Minute Lecture for more chapter-by-chapter summaries and academic support for physician assistants.