NSG 554 / NSG554 EXAM 2 STUDY
GUIDE: Dermatology, Burns &
Infectious Skin Conditions –
Complete Questions &Answers for
Wilkes University FNP Program
(2026/2027 Update)
QUESTION 1: What is the hallmark symptom of atopic dermatitis?
ANSWER: Pruritus (itching) is the hallmark symptom. The condition
presents with ill-defined, scaly, red plaques typically on the face, neck,
and upper trunk. During flare-ups, the lesions may become widespread
and weeping.
QUESTION 2: What is the first-line topical treatment for atopic
dermatitis on the face?
ANSWER: Mid-potency topical corticosteroids, specifically 0.1%
triamcinolone acetonide (Class 4). Emollients and moisturizers should be
used as the foundation of therapy for barrier repair. Stronger agents like
0.05% fluocinonide (Class III) should be avoided on the face.
QUESTION 3: What organism is associated with seborrheic dermatitis?
ANSWER: Malassezia yeast overgrowth. The condition presents with
greasy, yellowish scales on the scalp, eyebrows, nasolabial folds, and
,chest. Treatment includes ketoconazole shampoo 1-2 times weekly,
topical antifungals, and short-term use of low-potency corticosteroids.
QUESTION 4: What distinguishes rosacea from acne vulgaris?
ANSWER: Rosacea presents with papules and pustules WITHOUT
comedones, which is the key distinguishing feature from acne vulgaris.
Rosacea also presents with flushing, persistent erythema, and
telangiectasias. Common triggers to avoid include sun exposure, alcohol,
spicy foods, and temperature extremes.
QUESTION 5: What is the treatment algorithm for acne vulgaris based
on severity?
ANSWER: For mild acne, use topical retinoids such as tretinoin or
adapalene with or without benzoyl peroxide. For moderate acne, add
topical antibiotics like clindamycin or oral antibiotics such as doxycycline
or minocycline. For severe or cystic acne, use oral isotretinoin with
monitoring for teratogenicity and depression. Topical retinoids cause
photosensitivity, so sunscreen use is required.
QUESTION 6: What are the key clinical features of psoriasis?
ANSWER: Well-demarcated, erythematous plaques with silvery scales
typically on extensor surfaces such as elbows and knees, as well as the
scalp and nails. Nail changes include pitting and onycholysis. Treatment
options range from topical corticosteroids and vitamin D analogs for
mild disease to phototherapy, systemic agents like methotrexate, and
biologics such as adalimumab for moderate to severe disease.
,QUESTION 7: What are the clinical features and treatment of
hidradenitis suppurativa?
ANSWER: This is a chronic inflammatory follicular condition affecting
intertriginous areas including the axillae, groin, inframammary region,
and perianal area. Painful nodules progress to abscesses, sinus tracts,
and scarring. Treatment includes weight loss and smoking cessation,
topical clindamycin, oral doxycycline for anti-inflammatory effects,
adalimumab for moderate to severe cases, and surgical drainage or
excision for chronic lesions.
QUESTION 8: What is the treatment approach for vitiligo?
ANSWER: Vitiligo is caused by autoimmune destruction of melanocytes
resulting in milk-white depigmented macules or patches. Treatment
options include topical corticosteroids with limited efficacy, topical
calcineurin inhibitors like tacrolimus especially for facial involvement,
narrowband UVB phototherapy, and depigmentation therapy with
monobenzone for extensive disease.
QUESTION 9: What is bullous pemphigoid and how is it diagnosed?
ANSWER: Bullous pemphigoid affects patients over age 60 equally in
males and females. It begins with a prodromal phase of pruritus followed
by large, tense subepidermal blisters with clear or hemorrhagic exudate.
Triggers include infections like HIV, hepatitis, and EBV, as well as trauma,
burns, and medications including ACE inhibitors, NSAIDs, penicillins, and
furosemide. The gold standard for diagnosis is biopsy with direct
immunofluorescence microscopy. Complications include
hyperpigmentation, hypopigmentation, depression, and secondary
infection. First-line treatment is corticosteroids either topical or oral, with
caution needed due to increased infection risk in immunocompromised
, patients. Pruritus management and immunosuppressive agents like
azathioprine require dermatology consultation and referral.
QUESTION 10: What is the difference between androgenetic alopecia,
alopecia areata, telogen effluvium, and traction alopecia?
ANSWER: Androgenetic alopecia presents as male or female pattern
progressive thinning and is treated with minoxidil or finasteride in males.
Alopecia areata presents as patchy, well-circumscribed hair loss caused
by autoimmunity and is treated with topical or intralesional
corticosteroids and immunotherapy. Telogen effluvium presents as
diffuse shedding occurring 2-3 months after a stressor and resolves
spontaneously with reassurance. Traction alopecia results from
mechanical tension from tight hairstyles and resolves with removal of the
causative traction. Diagnostic workup includes trichoscopy, scalp biopsy
if scarring alopecia is suspected, and laboratory testing including TSH,
ferritin, B12, zinc, and ANA if autoimmune etiology is suspected.
QUESTION 11: What is the clinical presentation and treatment of herpes
zoster?
ANSWER: Herpes zoster presents with a prodrome of tingling, pain, and
burning in a dermatomal distribution followed by vesicles in a single
unilateral dermatome that evolve to pustules and then crusting. The
thoracic and lumbar roots are most commonly affected. Treatment
includes antivirals such as famciclovir, valacyclovir, or acyclovir initiated
within 72 hours of rash onset for best efficacy, along with analgesics for
pain including gabapentin or pregabalin for neuropathic pain. Post-
herpetic neuralgia is a complication defined as persistent pain lasting
more than 90 days. Patient education should emphasize that
immunocompromised patients are at higher risk for dissemination,
patients should avoid contact with pregnant women and
GUIDE: Dermatology, Burns &
Infectious Skin Conditions –
Complete Questions &Answers for
Wilkes University FNP Program
(2026/2027 Update)
QUESTION 1: What is the hallmark symptom of atopic dermatitis?
ANSWER: Pruritus (itching) is the hallmark symptom. The condition
presents with ill-defined, scaly, red plaques typically on the face, neck,
and upper trunk. During flare-ups, the lesions may become widespread
and weeping.
QUESTION 2: What is the first-line topical treatment for atopic
dermatitis on the face?
ANSWER: Mid-potency topical corticosteroids, specifically 0.1%
triamcinolone acetonide (Class 4). Emollients and moisturizers should be
used as the foundation of therapy for barrier repair. Stronger agents like
0.05% fluocinonide (Class III) should be avoided on the face.
QUESTION 3: What organism is associated with seborrheic dermatitis?
ANSWER: Malassezia yeast overgrowth. The condition presents with
greasy, yellowish scales on the scalp, eyebrows, nasolabial folds, and
,chest. Treatment includes ketoconazole shampoo 1-2 times weekly,
topical antifungals, and short-term use of low-potency corticosteroids.
QUESTION 4: What distinguishes rosacea from acne vulgaris?
ANSWER: Rosacea presents with papules and pustules WITHOUT
comedones, which is the key distinguishing feature from acne vulgaris.
Rosacea also presents with flushing, persistent erythema, and
telangiectasias. Common triggers to avoid include sun exposure, alcohol,
spicy foods, and temperature extremes.
QUESTION 5: What is the treatment algorithm for acne vulgaris based
on severity?
ANSWER: For mild acne, use topical retinoids such as tretinoin or
adapalene with or without benzoyl peroxide. For moderate acne, add
topical antibiotics like clindamycin or oral antibiotics such as doxycycline
or minocycline. For severe or cystic acne, use oral isotretinoin with
monitoring for teratogenicity and depression. Topical retinoids cause
photosensitivity, so sunscreen use is required.
QUESTION 6: What are the key clinical features of psoriasis?
ANSWER: Well-demarcated, erythematous plaques with silvery scales
typically on extensor surfaces such as elbows and knees, as well as the
scalp and nails. Nail changes include pitting and onycholysis. Treatment
options range from topical corticosteroids and vitamin D analogs for
mild disease to phototherapy, systemic agents like methotrexate, and
biologics such as adalimumab for moderate to severe disease.
,QUESTION 7: What are the clinical features and treatment of
hidradenitis suppurativa?
ANSWER: This is a chronic inflammatory follicular condition affecting
intertriginous areas including the axillae, groin, inframammary region,
and perianal area. Painful nodules progress to abscesses, sinus tracts,
and scarring. Treatment includes weight loss and smoking cessation,
topical clindamycin, oral doxycycline for anti-inflammatory effects,
adalimumab for moderate to severe cases, and surgical drainage or
excision for chronic lesions.
QUESTION 8: What is the treatment approach for vitiligo?
ANSWER: Vitiligo is caused by autoimmune destruction of melanocytes
resulting in milk-white depigmented macules or patches. Treatment
options include topical corticosteroids with limited efficacy, topical
calcineurin inhibitors like tacrolimus especially for facial involvement,
narrowband UVB phototherapy, and depigmentation therapy with
monobenzone for extensive disease.
QUESTION 9: What is bullous pemphigoid and how is it diagnosed?
ANSWER: Bullous pemphigoid affects patients over age 60 equally in
males and females. It begins with a prodromal phase of pruritus followed
by large, tense subepidermal blisters with clear or hemorrhagic exudate.
Triggers include infections like HIV, hepatitis, and EBV, as well as trauma,
burns, and medications including ACE inhibitors, NSAIDs, penicillins, and
furosemide. The gold standard for diagnosis is biopsy with direct
immunofluorescence microscopy. Complications include
hyperpigmentation, hypopigmentation, depression, and secondary
infection. First-line treatment is corticosteroids either topical or oral, with
caution needed due to increased infection risk in immunocompromised
, patients. Pruritus management and immunosuppressive agents like
azathioprine require dermatology consultation and referral.
QUESTION 10: What is the difference between androgenetic alopecia,
alopecia areata, telogen effluvium, and traction alopecia?
ANSWER: Androgenetic alopecia presents as male or female pattern
progressive thinning and is treated with minoxidil or finasteride in males.
Alopecia areata presents as patchy, well-circumscribed hair loss caused
by autoimmunity and is treated with topical or intralesional
corticosteroids and immunotherapy. Telogen effluvium presents as
diffuse shedding occurring 2-3 months after a stressor and resolves
spontaneously with reassurance. Traction alopecia results from
mechanical tension from tight hairstyles and resolves with removal of the
causative traction. Diagnostic workup includes trichoscopy, scalp biopsy
if scarring alopecia is suspected, and laboratory testing including TSH,
ferritin, B12, zinc, and ANA if autoimmune etiology is suspected.
QUESTION 11: What is the clinical presentation and treatment of herpes
zoster?
ANSWER: Herpes zoster presents with a prodrome of tingling, pain, and
burning in a dermatomal distribution followed by vesicles in a single
unilateral dermatome that evolve to pustules and then crusting. The
thoracic and lumbar roots are most commonly affected. Treatment
includes antivirals such as famciclovir, valacyclovir, or acyclovir initiated
within 72 hours of rash onset for best efficacy, along with analgesics for
pain including gabapentin or pregabalin for neuropathic pain. Post-
herpetic neuralgia is a complication defined as persistent pain lasting
more than 90 days. Patient education should emphasize that
immunocompromised patients are at higher risk for dissemination,
patients should avoid contact with pregnant women and
