CHAPTER 15- Dermatology:Integumentary

Question 1

When performing a skin assessment, what is the most vital component of the assessment?

1. Assessing skin turgor for hydration status
2. Visual examination of the skin surface
3. A thorough history
4. A biopsy of any unusual looking lesions

Answer 1

3. A thorough history

A thorough history is invaluable in identifying skin disorders. While the other answers are correct and may be considered, they are not as vital to the assessment.

Question 2

The NP is using the correct terminology to describe the morphology of a lesion. Which of the following is an appropriate description?

1. “The lesion has irregular borders.”
2. “The lesion is a macule.”
3. “The lesion is erythematous.”
4. “The lesion is scaly.”

Answer 2

2. “The lesion is a macule.”

Morphology is the term used to describe the shape of a lesion such as a macule, papule, or patch.

Question 3

A patch can be differentiated from a macule by observing that:

1. A patch is less than 1 cm in diameter.
2. A patch is elevated, firm, and circumscribed and less than 1 cm in diameter.
3. A patch is an elevated, firm, rough lesion with a flat top surface and greater than 1 cm in diameter.
4. A patch is a flat, non-palpable, irregular-shaped macule greater than 1 cm in diameter.

Answer 3

4. A patch is a flat, non-palpable, irregular-shaped macule greater than 1 cm in diameter.

The primary difference between a macule and a patch is that the patch is > 1 cm in size.

Question 4

Vitiligo can be described as what?

1. Distinct raised areas of the skin that are pruritic
2. Hypo-pigmented macular lesions ranging in size from 5 mm to 5 cm or greater
3. A loss of skin pigment and hair due to injury at the base of the hair follicle
4. A progressive thickening and hardening of the epidermis

Answer 4

2. Hypo-pigmented macular lesions ranging in size from 5 mm to 5 cm or greater

By definition, vitiligo consists of hypopigmented lesions of varying size.

Question 5

Treatment for vitiligo may include which of the following?

1. Antihistamines
2. Griseofulvin
3. Topical steroids
4. Lamisil cream

Answer 5

3. Topical steroids

Although the etiology remains unknown, vitiligo may have an autoimmune component and, therefore, may respond to corticosteroid therapy.

Question 6

A patient presents to the office with concerns about sudden losses of patches of hair from her scalp. She denies any recent changes in use of hair products. She does not pull or tug at her hair. The NP diagnoses the patient with alopecia areata. Which of the following statements made by the NP would provide the most reassurance to the patient?

1. “There is no treatment but it is always a benign condition.”
2. “If we can identify the causative agent, we may be able to prevent further hair loss.”
3. “A 1% topical naftifine cream (Naftin) applied bid for 2–4 weeks may help prevent further hair loss.”
4. “Eighty percent of all people with this condition will have spontaneous re-growth of hair within one year.”

Answer 6

4. “Eighty percent of all people with this condition will have spontaneous re-growth of hair within one year.”

This is the best choice since it is the only answer that provides reassurance to the patient by providing information that hair growth is likely to reoccur spontaneously.

Question 7

A 35-year-old female patient is seen in the primary care office with concerns about multiple small, oval, pink, scaling macules that have appeared on her trunk. There is no associated pain or pruritus. There is one significantly larger scaly patch observed on the abdomen. The NP diagnoses the patient as having what?

1. Roseola
2. Pityriasis rosea
3. Contact dermatitis
4. Rosacea

Answer 7

2. Pityriasis rosea

The significantly larger scaly patch that is seen on the patient’s abdomen is known as a “herald patch” and is a classic sign seen with pityriasis rosea.

Question 8

An 8-year-old male child is seen in the clinic with a superficial pustule along his inner forearm that started as a mosquito bite. There is a characteristic honey-colored crust covering the entire lesion. The NP diagnoses the patient with which of the following?

1. Staph aureus or Group A beta hemolytic streptococcus infection
2. Group B: Beta hemolytic streptococcus infection
3. Community-acquired Methicillin-resistant staph aureus
4. Tinea corporis

Answer 8

1. Staph aureus or Group A beta hemolytic streptococcus infection

The patient is showing classic signs of impetigo which is consistent with a history of scratching a pruritic lesion such as a mosquito bite.

Question 9

A patient presents to the clinic with complaints of itching and flaking to bilateral feet. The NP observes that there is a characteristic macerated appearance between the toes. The NP diagnoses the patient with which of the following?

1. Tinea pedis
2. Onychomycosis
3. Tinea versicolor
4. Seborrheic dermatitis

Answer 9

1. Tinea pedis

The macerated appearance between the toes is consistent with a tinea infection and is commonly called “athlete’s foot.”

Question 10

A patient is seen in the primary care office. The patient has a maculo-papular rash with distinct vesicles on the lateral left trunk that follows along a dermatome. The patient states that the rash has been there for three days. Which of the following is important educational information that should be provided to the patient?

1. The patient is experiencing a reactivation of the chicken pox virus and is not contagious.
2. The patient is contagious and must avoid pregnant woman, immunocompromised individuals, and non-immunized children.
3. The patient is only contagious for the first 48–72 hours that the rash is present.
4. The patient is not contagious. The rash may remain for many months and there is no treatment.

Answer 10

2. The patient is contagious and must avoid pregnant woman, immunocompromised individuals, and non-immunized children.

This is a reactivation of the chicken pox virus and the patient is contagious. Precautions should be taken to avoid exposure to non-immune individuals.

Question 11

Which of the following is the preferred treatment for herpes zoster (shingles)?

1. Ketoconazole 200 mg tablet po daily × 10–14 days
2. Lotrisome topical cream 0.5%; apply to affected area for two weeks
3. Diflucan 150 mg one tablet po daily for 14 days
4. Valcyclovir 1 gm tid × 7 days

Answer 11

4. Valcyclovir 1 gm tid × 7 days

Herpes zoster is a virus and therefore would respond best to antiviral treatment. The treatment should be started as early as possible to shorten the duration and intensity of the outbreak.

Question 12

Onychomycosis is:

1. Caused by a viral infection.
2. Caused by a fungal infection.
3. Caused by a bacterial infection.
4. There is no known etiology.

Answer 12

2. Caused by a fungal infection.

Onychomycosis, by definition, is a fungal infection of the nails. It is more commonly seen in the toenails but may be seen in the fingernails as well.

Question 13

The preferred therapy for onychomycosis is topical agents. If the NP uses oral agents, the NP should first obtain lab work to determine what?

1. The patient’s renal function
2. The patient’s hepatic function
3. The patient’s coagulation factors
4. The patient’s immune-competency

Answer 13

2. The patient’s hepatic function

If an oral antifungal agent is used, the patient’s hepatic function needs to be assessed first because the medication is metabolized extensively within the liver.

Question 14

Verruca vulgaris is more commonly known as warts. They are cutaneous neoplasms caused by which of the following?

1. A fungal infection
2. A bacterial infection
3. HPV virus
4. A dermatophyte

Answer 14

3. HPV virus

There are more than 50 different types of herpes virus responsible for the growth of warts.

Question 15

A patient is requesting more information about several warts that have appeared along his fingers on both hands. Which of the following is appropriate educational information for this patient?

1. There is no known treatment, but generally most warts will resolve in 1–2 years.
2. They are not spread through casual contact but rather through contact with an open area.
3. They are usually confined to the hands or the feet.
4. They are more common in women than in men.

Answer 15

1. There is no known treatment, but generally most warts will resolve in 1–2 years.

There is no cure for warts, but most warts will resolve without any intervention. They are spread through contact and do not need to be in contact with an open skin area.

Question 16

Lichenification is a term used to describe which of the following?

1. Scar tissue formation that is out of proportion to the healing process
2. Thick fibrous tissue that replaces normal skin tissue
3. A linear crack in the epidermis that has a scaly appearance
4. A cutaneous thickening and hardening of the epidermis

Answer 16

4. A cutaneous thickening and hardening of the epidermis

Lichenification can occur anywhere on the body. It is a thickening of the skin related to persistent rubbing or itching of an area that occurs over an extended period of time.

Question 17

The term bulla is used to describe a lesion that is:

1. Elevated, firm, and circumscribed.
2. A vesicle or large fluid-filled blister.
3. An elevated firm rough lesion with a flat top surface.
4. A large grouping of keritanized cells with thick oily walls.

Answer 17

2. A vesicle or large fluid-filled blister.

A bulla is a large fluid-filled blister. It is commonly seen in patients who have a severe allergy to poison ivy, poison oak, or poison sumac. Bullae can appear in response to any injury or allergic reaction.

Question 18

The patient presents to the office with an apparent allergic reaction to an unknown antigen. The patient has pruritic hives on his arms, legs, trunk, and face. The patient has no difficulty breathing or swallowing, his lungs are clear, and there is no swelling of the lips or tongue. With this information, the NP should choose which of the following options for treatment?

1. One-time dose of epinephrine via EpiPen stat in office
2. Oral antihistamines, cool compresses, and oral corticosteroids
3. Topical steroid cream to be applied to all affected areas × 1 week or until lesions disappear
4. Using second-generation antihistamines and warm compresses to affected areas for 20 minutes tid

Answer 18

2. Oral antihistamines, cool compresses, and oral corticosteroids

The patient is having an allergic reaction but does not exhibit any signs or symptoms of impending anaphylaxis. For this reason, it is reasonable to treat the patient with oral antihistamines and corticosteroids. The patient should be prescribed an EpiPen because subsequent exposure to the antigen may cause a more severe reaction.

Question 19

A patient presents to the office with complaints of skin inflammation, intense itching, and flaky skin on the elbows and knees. The NP diagnoses the patient with eczema. What would the NP expect to find when conducting the personal and family history?

1. Mother has a history of asthma and COPD.
2. Father had an MI at age 52.
3. Sister has type 2 diabetes mellitus.
4. The patient had a tonsillectomy at age 5.

Answer 19

1. Mother has a history of asthma and COPD.

Patients with eczema often have a personal or family history of allergies, such as those commonly seen with patients who have asthma.

Question 20

A patient comes to the clinic concerned about non-pruritic lesions that are present on both of his elbows. The lesions are pink, sharply demarcated papular plaques covered with silvery scale. The NP diagnoses the patient with which of the following?

1. Eczema
2. Dermatitis
3. Xerosis
4. Psoriasis

Answer 20

4. Psoriasis

The patient has a classic presentation of psoriasis. The location and appearance are enough to diagnose the patient.

Question 21

A 35-year-old female with a past medical history that includes psoriasis presents to the office for an annual physical. While obtaining a detailed history, the NP recognizes that it would be important to inquire about any personal history of:

1. Sexually transmitted diseases.
2. Autoimmune disorders.
3. Joint pains.
4. Migraine headaches.

Answer 21

3. Joint pains.

Psoriatic arthritis is commonly found in patients who have psoriasis. It is important to assess this early in the patient’s history.

Question 22

While performing a complete physical exam, the NP notes that the patient has very dry, scaly skin on all of the patient’s extremities. The NP inquires about the use of moisturizers and fragrances and asks if there is a personal or family history of:

1. Asthma.
2. Rosacea.
3. Diabetes.
4. Hypothyroidism.

Answer 22

4. Hypothyroidism.

Many patients with dry scaly skin are found to have hypothyroidism. A patient with no other personal history that would explain the dry, scaly skin appearance should have a TSH level done.

Question 23

What is the most common lesion seen in dermatology?

1. Basal cell skin cancer
2. Squamous cell skin cancer
3. Actinic keratosis
4. NMSC (non-melanoma skin cancer)

Answer 23

3. Actinic keratosis

Actinic keratosis is a pre-cancerous lesion and is the most common lesion seen in dermatology.

Question 24

What is the most common type of skin cancer?

1. Basal cell carcinoma
2. Squamous cell carcinoma
3. Melanoma
4. Seborrheic keratosis

Answer 24

1. Basal cell carcinoma

Basal cell carcinoma is the most common form of skin cancer. Squamous cell carcinoma is the second most common form.

Question 25

An 18-year-old female patient presents to the office with complaints of papulopustular, cystic acne to her forehead, chin, and upper back areas. The NP is concerned with psychosocial effects as well as physiological long-term scarring. The NP decides to initiate therapy with which of the following?

1. Exfoliation therapy
2. Topical clindamycin
3. Isotretinoin (Accutane)
4. Retinoids

Answer 25

3. Isotretinoin (Accutane)

Isotretinoin is the most effective of the treatments listed. It is a known teratogen and therefore is only used in severe cases of acne that interfere with the patient’s quality of life.

Question 26

The NP prescribes Isotretinoin for an 18-year-old female patient with severe cystic acne. The pharmacist receives the prescription but refuses to fill it. What is the most likely reason for the pharmacist’s refusal?

1. The NP is not registered with the IPLEDGE program.
2. The patient must first show a negative pregnancy test to the pharmacist.
3. The pharmacist feels it is an inappropriate medication for an 18-year-old female patient.
4. Female patients that are potentially fertile are not allowed to have Isotretinoin therapy due to its severe teratogenic effects.

Answer 26

1. The NP is not registered with the IPLEDGE program.

The IPLEDGE program is designed to increase the awareness and accountability of both the health care provider (prescriber) and the pharmacist. These professionals are required to complete a program and be certified in the prescribing and dispensing of medications that are highly teratogenic.

Question 27

A patient is diagnosed with alopecia areata. The nurse practitioner reassures the patient that there is no permanent scarring or damage to the hair follicle and that hair growth will likely return within one year. To prevent further episodes, the NP suggests that the patient do which of the following?

1. Take 2000 international units of Vitamin D once daily.
2. Use baby shampoo or shampoo that contains no perfumes or dyes.
3. Consider practicing daily meditation, yoga, or guided imagery to reduce stress.
4. Avoid tight hats and restrictive headbands.

Answer 27

3. Consider practicing daily meditation, yoga, or guided imagery to reduce stress.

Although there is no known etiology of alopecia areata, it is believed that stress may be a trigger. Practicing daily stress-relieving activities may decrease the chance of a reoccurrence.

Question 28

The term dermatographism refers to what?

1. Skin welts or redness that appears when the skin is scratched or stroked firmly
2. The ability to correctly identify an item that is placed in the hand when the eyes are closed
3. The visible burrows left by chiggers burrowing under the skin
4. Areas of hypopigmentation that are the result of the presence of dermatophytes

Answer 28

1. Skin welts or redness that appears when the skin is scratched or stroked firmly

Dermatographism is, by definition, the development of skin welts when the skin is scratched or stroked firmly.

Question 29

A patient complains of a pruritic red rash that appeared on his body several days ago. The NP obtains a skin scraping, applies KOH, and visualizes multiple hyphae under the microscope. The nurse practitioner diagnoses the patient with which of the following?

1. Herpes zoster
2. Seborrheic dermatitis
3. Tinea corporis
4. Onychomycosis

Answer 29

3. Tinea corporis

The appearance of hyphae under the microscope is an indicator that yeast is present. Yeast is a fungus. Overgrowth of yeast on the skin is a common occurrence.

Question 30

A 19-year-old female college student is seen in the health center complaining of several pustules that have appeared in her groin area after shaving. The NP diagnoses the patient with folliculitis. The NP obtains a pregnancy test and then prescribes which of the following?

1. Topical clindamycin and oral doxycycline
2. Topical imiquimod lotion
3. Azithromycin 250 mg; take 2 tabs on day one and then one tab for four days thereafter
4. Medrol dosepak × 5 days

Answer 30

1. Topical clindamycin and oral doxycycline

Folliculitis is treated with both topical and oral antibiotics. A pregnancy test should always be done first on a young female to avoid the risk of exposure to a known teratogen.

Question 31

The nurse practitioner can expect to find more frequent skin conditions in which population?

1. The African American population
2. The diabetic population
3. People who primarily work outdoors
4. Health care workers

Answer 31

2. The diabetic population

Diabetics are more prone to skin conditions due to the fact that both bacteria and fungi thrive in warm moist environments where large amounts of glucose may be present.

Question 32

What is the first-line treatment for onychomycosis?

1. Topical antifungal agents
2. Oral antifungal agents
3. Oral antibiotic agents
4. Oral antiviral agents

Answer 32

1. Topical antifungal agents

Although they may not be as effective as oral antifungal agents, topical antifungal agents are the preferred first-line treatment. Oral antifungal agents are hepatotoxic.

Question 33

The NP is evaluating a 57-year-old Caucasian female who is complaining of persistent facial erythema. The NP observes inflammatory papules and pustules on the periorificial area of the face. There is also dilated prominent telangiectasia evident over the cheekbones. The nurse practitioner diagnoses the patient with which of the following?

1. Roseola
2. Rubeola
3. Acne
4. Rosacea

Answer 33

4. Rosacea

This is a classic presentation of rosacea, which is often seen in middle-aged men and women.

Question 34

The patient has been diagnosed with eczema and the nurse practitioner is providing educational recommendations for prevention of exacerbations. All of the following would be effective EXCEPT:

1. Antihistamines prn to control pruritus.
2. Topical steroids prn.
3. Warm showers bid to open pores.
4. Daily moisturizing to all affected areas.

Answer 34

3. Warm showers bid to open pores.

Patients with eczema should try to use cool moisture when possible and should try to avoid the drying effect that occurs with frequent showers or hot showers.

Question 35

What is the most effective treatment for cysts?

1. Oral antibiotics
2. Hibiclens scrub
3. Incision and drainage
4. Topical steroids

Answer 35

3. Incision and drainage

Cysts are self-contained pockets of bacteria and WBCs. The best treatment is to open the self-contained cyst and allow drainage to occur. Oral antibiotics or topical antibiotics may be prescribed after the I&D (incision and drainage).

Question 36

A patient has been told that he should have Mohs surgery on a cancerous lesion. The patient asks what Mohs surgery is. The nurse practitioner explains that:

1. The cancerous lesion is removed, as well as the surrounding lymph nodes.
2. The surface area of the lesion is excised and the underlying area is cauterized to prevent further growth.
3. The lesion is excised and examined under a microscope to determine if wound edges are free from cancer or if further excision is required.
4. A wide excision is performed to avoid having to do further surgery.

Answer 36

3. The lesion is excised and examined under a microscope to determine if wound edges are free from cancer or if further excision is required.

The purpose of Mohs surgery is to minimize the amount of healthy skin tissue that is excised, while ensuring that all of the cancerous tissue is removed.

Question 37

A patient’s skin on his lower extremities is described by the NP as taut, shiny, and hairless. The nurse practitioner is aware that this skin appearance is consistent with which of the following?

1. Aging skin
2. Venous insufficiency
3. Arterial insufficiency
4. Chronic, long-term sun exposure

Answer 37

3. Arterial insufficiency

A patient with decreased arterial flow will often present with taut, shiny, and hairless lower extremities. The presence of hair on the lower extremities or on the toes is a good indicator of adequate blood flow.

Question 38

The patient presents with thin, friable skin with multiple bruised areas to the extremities. The nurse practitioner is aware that the patient’s history may reveal which of the following?

1. A history of insulin-dependent type 2 diabetes mellitus
2. Hypothyroidism
3. Long-term corticosteroid use
4. Peripheral vascular disease

Answer 38

3. Long-term corticosteroid use

Any patient chronically exposed to an abundance of cortisol will present with thin, friable skin that bruises easily. This can be from either exogenous sources (oral corticosteroids) or an endogenous source such as that seen with Cushing’s syndrome.

Question 39

A patient presents to the clinic with complaints of pruritus of the left hand. The NP observes several erythematous papules and linear burrows in the interdigital web spaces of the left hand. The nurse practitioner diagnoses the patient with which of the following?

1. Tinea corporis
2. Scabies
3. Lice
4. Onychomycosis

Answer 39

2. Scabies

Linear burrows are a classic sign of scabies. Scabies will often present in the interdigital areas of the hands, but are not limited to this area, and may appear anywhere on the body. The NP should examine all close family contacts because scabies is often found in crowded living conditions.

Question 40

A 45-year-old male patient presents to the clinic concerned about a mole on his upper back area. The nurse practitioner examines the mole and notes that it is well circumscribed, dark brown, circular, and 7 mm in diameter. The NP refers the patient to dermatology for excision and biopsy. Which of the following characteristics was most concerning to the NP?

1. Location
2. Size
3. Color
4. Border configuration

Answer 40

2. Size

Using the ABCDE method, the NP would be aware that any mole that is > 6 mm in diameter should be excised and evaluated for possible melanoma.

Question 41

A patient presents to the primary care provider concerned about a distinct rash that has appeared on his lower leg. It is non-pruritic, 6 cm in diameter, with an annular homogenous erythema appearance, and central clearing. The NP inquires as to whether the patient:

1. Has young children in the household with tinea corporis (ringworm).
2. Is immunocompromised.
3. Has been outdoors doing yard work, or has been camping or hiking in the past several weeks.
4. Has had a rash that appeared like this in the past.

Answer 41

3. Has been outdoors doing yard work, or has been camping or hiking in the past several weeks.

The patient is presenting with erythema migrans, which is commonly called the “bull’s-eye” rash. Inquiry should be made as to whether the patient has potentially been exposed to a deer tick in recent weeks.

Question 42

The nurse practitioner is documenting the appearance of a lesion. The NP writes that the lesion is “pearly” in appearance. What characteristic is the NP describing?

1. Morphology
2. Distribution
3. Arrangement
4. Pigmentation

Answer 42

4. Pigmentation

When describing a lesion, it is important that the NP includes all characteristics of that lesion. Pearly is a descriptive term for the pigmentation.

Question 43

Most cases of melanoma are seen in which of the following?

1. Caucasian females over the age of 50
2. Caucasian males over the age of 50
3. Caucasian females with blue eyes and red or blond hair
4. Any person of northern European descent

Answer 43

2. Caucasian males over the age of 50

Men over the age of 50 have the highest incidence of melanoma.

Question 44

An important prognostic factor for a patient diagnosed with melanoma is which of the following?

1. The number of blistering sunburns the patient has experienced over his lifetime.
2. A family history of melanoma.
3. The thickness of the lesion and if ulceration is present at the time of diagnosis.
4. The diameter of the lesion.

Answer 44

3. The thickness of the lesion and if ulceration is present at the time of diagnosis.

Characteristics such as thickening or ulceration at the time of diagnosis is the most important factor in the patient’s prognosis. The other answers are indicative of the patient’s risk for melanoma.

Question 45

A 35-year-old female patient presents to the nurse practitioner for a routine physical exam. During the skin assessment, the patient comments about a lesion that is present on the dorsal portion of her lower left leg. Which of the following statements made by the patient is the most concerning?

1. “I think this mole is a different color than the other moles I have.”
2. “This mole seems like it grew overnight.”
3. “This mole is larger than the other moles I have on my body.”
4. “Sometimes this mole is itchy.”

Answer 45

2. “This mole seems like it grew overnight.”

Any mole that has grown quickly must be immediately evaluated and biopsied because this is a typical characteristic of a malignant melanoma.

Question 46

A patient’s chances of developing a melanoma is closely related to which of the following?

1. The number of melanocytes present in the dermis
2. The number of blistering sunburns the patient has experienced in his or her lifetime
3. The amount of time he/she has spent outdoors
4. Chronic exposure to known carcinogens such as free radicals

Answer 46

2. The number of blistering sunburns the patient has experienced in his or her lifetime

The number of blistering sunburns a person has had in their lifetime is a significant factor. A patient with one or more blistering sunburns doubles their chance of developing melanoma.

Question 47

An 18-year-old male of African American descent is traveling to a tropical area for vacation. He asks the nurse practitioner whether it is necessary for him to wear a sunscreen higher than SPF 8. The NP makes her recommendation to the patient based on knowledge that:

1. The large amount of deeply pigmented melanocytes will protect him from sun damage.
2. The patient can sunburn and is still considered at risk for developing melanoma.
3. The patient is not at risk for melanoma but should try to avoid sunburn to prevent skin damage.
4. Protecting his skin now will prevent premature skin aging.

Answer 47

2. The patient can sunburn and is still considered at risk for developing melanoma.

African Americans have a larger number of melanocytes but are still capable of burning their skin with UV rays. A sunscreen SPF of 30 is the standard recommendation for all persons exposed to the sun’s rays.

Question 48

Actinic keratosis is often described by the patient as which of the following?

1. A scaly spot that won’t go away.
2. A round, elevated lesion with a white center and a pale red border.
3. A firm, elevated 1–2 cm nodule with distantly palpable borders.
4. A birthmark or “beauty mark.”

Answer 48

1. A scaly spot that won’t go away.

Actinic keratosis is the most common lesion seen in dermatology. It may present as a persistent scaly area of skin or a distinct lesion.

Question 49

The nurse practitioner is describing lesions that are observed on a patient. The NP writes “The lesions are localized to the left lower extremity.” The nurse practitioner is identifying the:

1. Distribution.
2. Morphology.
3. Secondary characteristics.
4. Arrangement.

Answer 49

1. Distribution.

The distribution of lesions can assist with assessment and diagnosis. Distribution refers to where the lesions are located on the body.

Question 50

Actinic keratosis is the most common lesion seen in dermatology. When providing education to the patient about actinic keratosis, the NP explains that:

1. It is a form of skin cancer.
2. It is a pre-cancerous lesion.
3. It is an area of increased pigmentation.
4. It is an area of hypopigmentation caused by sun damage.

Answer 50

2. It is a pre-cancerous lesion.

Although they are the most common lesion seen in dermatology, it is important for the patient who presents with actinic keratosis to understand that these are pre-cancerous lesions that need to be assessed and/or removed to prevent progression to skin cancer.