Test Bank For Review of Dermatology, 2nd Edition
Authors: Ali Alikhan,Thomas L.H. Hocker
,Chapter 1: Basic Science
Review of Dermatology, 2nd Edition (Original Questions Only)
Clinical/Application MCQs
Question 1
A 24-year-old woman presents with recurrent episodes of blistering after minor
trauma. Skin biopsy demonstrates separation between the epidermis and dermis with
preservation of the basal keratinocyte layer. Which structure is most likely
dysfunctional?
A. Desmosomes
B. Hemidesmosomes
C. Tight junctions
D. Gap junctions
Correct Answer: B. Hemidesmosomes
Explanation
Hemidesmosomes anchor basal keratinocytes to the basement membrane. Defects
weaken dermal-epidermal adhesion, producing subepidermal blistering after
mechanical stress.
Why the other options are incorrect
A. Desmosomes
• Connect adjacent keratinocytes within the epidermis.
• Their disruption causes intraepidermal blistering rather than dermal-epidermal
separation.
C. Tight junctions
• Regulate paracellular permeability.
• They are not the primary structures responsible for epidermal attachment to
the basement membrane.
D. Gap junctions
• Permit intercellular communication through ion exchange.
, • They do not provide structural adhesion.
Question 2
A patient develops generalized erythema following extensive ultraviolet (UVB)
exposure. Which epidermal cell type is primarily responsible for initiating antigen
presentation after UV-induced injury?
A. Keratinocyte
B. Merkel cell
C. Langerhans cell
D. Melanocyte
Correct Answer: C. Langerhans cell
Explanation
Langerhans cells are dendritic antigen-presenting cells located within the epidermis.
They capture antigens, migrate to regional lymph nodes, and activate T lymphocytes.
Why the other options are incorrect
A. Keratinocyte
• Produces cytokines but is not a professional antigen-presenting cell.
B. Merkel cell
• Functions as a mechanoreceptor.
D. Melanocyte
• Produces melanin but does not primarily present antigen.
Question 3
A newborn has diffuse scaling and impaired temperature regulation. Which epidermal
layer is most directly responsible for preventing excessive transepidermal water loss?
A. Stratum basale
B. Stratum spinosum
C. Stratum granulosum
D. Stratum corneum
, Correct Answer: D. Stratum corneum
Explanation
The stratum corneum consists of corneocytes embedded in extracellular lipid
lamellae that create the primary permeability barrier.
Why the other options are incorrect
A. Stratum basale
• Responsible for keratinocyte proliferation.
B. Stratum spinosum
• Provides structural integrity through desmosomes.
C. Stratum granulosum
• Forms keratohyalin granules and contributes to barrier formation but is not the
completed barrier.
Question 4
A researcher studies fibroblast activity during wound healing. Which extracellular
matrix protein provides the greatest tensile strength to healed skin?
A. Elastin
B. Type I collagen
C. Laminin
D. Fibronectin
Correct Answer: B. Type I collagen
Explanation
Type I collagen is the dominant collagen in mature dermis and scars, providing tensile
strength.
Why the other options are incorrect
A. Elastin
• Provides elasticity rather than tensile strength.
C. Laminin
Authors: Ali Alikhan,Thomas L.H. Hocker
,Chapter 1: Basic Science
Review of Dermatology, 2nd Edition (Original Questions Only)
Clinical/Application MCQs
Question 1
A 24-year-old woman presents with recurrent episodes of blistering after minor
trauma. Skin biopsy demonstrates separation between the epidermis and dermis with
preservation of the basal keratinocyte layer. Which structure is most likely
dysfunctional?
A. Desmosomes
B. Hemidesmosomes
C. Tight junctions
D. Gap junctions
Correct Answer: B. Hemidesmosomes
Explanation
Hemidesmosomes anchor basal keratinocytes to the basement membrane. Defects
weaken dermal-epidermal adhesion, producing subepidermal blistering after
mechanical stress.
Why the other options are incorrect
A. Desmosomes
• Connect adjacent keratinocytes within the epidermis.
• Their disruption causes intraepidermal blistering rather than dermal-epidermal
separation.
C. Tight junctions
• Regulate paracellular permeability.
• They are not the primary structures responsible for epidermal attachment to
the basement membrane.
D. Gap junctions
• Permit intercellular communication through ion exchange.
, • They do not provide structural adhesion.
Question 2
A patient develops generalized erythema following extensive ultraviolet (UVB)
exposure. Which epidermal cell type is primarily responsible for initiating antigen
presentation after UV-induced injury?
A. Keratinocyte
B. Merkel cell
C. Langerhans cell
D. Melanocyte
Correct Answer: C. Langerhans cell
Explanation
Langerhans cells are dendritic antigen-presenting cells located within the epidermis.
They capture antigens, migrate to regional lymph nodes, and activate T lymphocytes.
Why the other options are incorrect
A. Keratinocyte
• Produces cytokines but is not a professional antigen-presenting cell.
B. Merkel cell
• Functions as a mechanoreceptor.
D. Melanocyte
• Produces melanin but does not primarily present antigen.
Question 3
A newborn has diffuse scaling and impaired temperature regulation. Which epidermal
layer is most directly responsible for preventing excessive transepidermal water loss?
A. Stratum basale
B. Stratum spinosum
C. Stratum granulosum
D. Stratum corneum
, Correct Answer: D. Stratum corneum
Explanation
The stratum corneum consists of corneocytes embedded in extracellular lipid
lamellae that create the primary permeability barrier.
Why the other options are incorrect
A. Stratum basale
• Responsible for keratinocyte proliferation.
B. Stratum spinosum
• Provides structural integrity through desmosomes.
C. Stratum granulosum
• Forms keratohyalin granules and contributes to barrier formation but is not the
completed barrier.
Question 4
A researcher studies fibroblast activity during wound healing. Which extracellular
matrix protein provides the greatest tensile strength to healed skin?
A. Elastin
B. Type I collagen
C. Laminin
D. Fibronectin
Correct Answer: B. Type I collagen
Explanation
Type I collagen is the dominant collagen in mature dermis and scars, providing tensile
strength.
Why the other options are incorrect
A. Elastin
• Provides elasticity rather than tensile strength.
C. Laminin
