1. Jessner solution is a commonly used peeling agent with ingredients consisting of salicylic acid, resorcinol, and which of the following agents?

a. Bichloroacetic acid

b. Glycolic acid

c. Lactic acid

d. Mandelic acid

2. Chemical peels may be classified by their depth of penetration. Which of the following would be classified as a deep peeling agent?

a. Glycolic acid 50%

b. Jessner solution

c. Phenol 88%

d. Trichloroacetic acid 35%

3. Topical medications are delivered in various types of vehicles. A mixture of water with powder describes which of the following vehicle?

a. Cream

b. Gel

c. Lotion

d. Solution

4. Which level of the epidermis would Langerhans cells be normally located?

a. Corneum

b. Lucidum

c. Granulosum

d. Spinosum

5. The Leser-Trelat sign is characterized by explosive development of which of the following lesions?

a. Seborrheic keratoses

b. Atypical nevi

c. Angiofibromas

d. Sebaceous hyperplasia

6. The presence of Sister Mary Joseph nodule is commonly associated with which of the following type of cancer?

a. Bladder

b. Breast

c. Gastric

d. Liver

7. A male adolescent presents to a dermatology clinic with brownish-black velvet-like plaque on his posterior neck. This condition may reflect the possibility of:

a. Diabetes

b. Hypertension

c. Cancer

d. Hypercholesterolemia

8. Gottron papules, reddish to purple colored papules, and plaques located on the distal and proximal metacarpal joints may be a sign of which of the following conditions?

a. Dermatomyositis

b. Lupus erythematosus

c. Scleroderma

d. Wegener's granulomatosis

9. Wilson's disease is a condition characterized by accumulation of which of the following substances in internal organs?

a. Iron

b. Zinc

c. Selenium

d. Copper

10. The cutaneous findings of Peutz-Jeghers syndrome include melanotic macules located on:

a. Lip

b. Axilla

c. Areola

d. Penis

1. c. The third ingredient of Jessner solution is lactic acid (Fabbrocini & Cacciapuoti, 2018).

2. c. Phenol 88% is a deep peeling agent, whereas trichloroacetic acid is classified as a medium-depth agent. Both glycolic acid 50% and Jessner solution are classified as superficial- to very-superficial-depth peeling agents (Fabbrocini & Cacciapuoti, 2018).

3. c. Lotions are a mixture of water mixed with powder. Ointments are an emulsion of solids in water that are suspended in oils. Creams are a mixture of oil and water, whereas solutions are a mixture of water with alcohol, glycol, and other liquids. Gels are semisolids formulated in an alcohol or water base. Foams are gas bubbles dispensed in a water base (Hashim, Chen, Hebert, & Kircik, 2019).

4. d. There are five layers of the epidermis. The corneum is considered the "brick and mortar" level that also contains the lipid matrix. The lucidum is found only on the palms and soles and provides a protective function. Most of the epidermis is the granulosum layer containing keratin and filaggrin. The spinosum layer contains Langerhans cells and ceramides. The basale layer contains some melanocytes and basal cells with integrins, which provides adhesion of the epidermis to the dermis (Bobonich, 2015).

5. a. Leser-Trelat sign is of a rapid onset in numerous new and enlarging seborrheic keratoses. It is considered a marker of cutaneous malignancies, most commonly breast, lymphoma, colon, and gastric adenocarcinomas (Requena, Requena, & Cockerell, 2018).

6. c. Sister Mary Joseph nodule is most commonly associated with gastric cancer. Sister Mary Joseph was a surgical assistant and recognized a pattern of an erythematous umbilical nodule with gastric cancers (McGee, 2018).

7. a. Acanthosis nigricans, a velvety brownish-black plaque often located on the posterior neck, is often associated with diabetes or the propensity to develop diabetes. Individuals usually have truncal obesity and may have either increased glucose levels or decreased insulin sensitivity (Voss, 2015).

8. a. Grotton papules are a clinical sign of dermatomyositis. They are small, less than 1 centimeter in size, reddish-purplish papules that may be found on joints of the fingers, elbows, knees, and medial malleoli (Coyner, Congelio, & Masterson, 2016).

9. d. Wilson's disease is a condition because of accumulation of copper in internal organs. The condition may be acquired or inherited. Individuals with excessive amounts of copper may exhibit cutaneous signs of pretibial hyperpigmentation, blue coloration of the lunula of the nails, and a greenish golden circle of pigment at the periphery of the cornea (Bandmann, Weiss, & Kaler, 2015).

10. a. Peutz-Jeghers syndrome is characterized by the development of melanocytic macules on the lip, mucosa surfaces, and, occasionally, acral and perioral areas. The syndrome is associated with hamartomatous polyps in the gastrointestinal tract. Individuals with Peutz-Jeghers have increased incidences of several types of cancers (Schwarzenberger & Callen, 2018).

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