Physician Assistant Exam Review Podcast

155 Benign vs Concerning Skin Lesions – "Do I Worry?" Patterns You'll See on PANCE


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In this episode of the Physician Assistant Exam Review Podcast, we walk through the "Do I worry?" side of derm: how to quickly sort benign vs concerning skin lesions using pattern recognition, not panic.

Instead of memorizing every lesion in isolation, you'll learn to organize them into buckets you'll actually see on exams and in clinic:

  • Keratotic lesions: Actinic keratosis vs seborrheic keratosis – rough "sandpaper" vs waxy "stuck‑on," and when premalignant SCC risk should be on your radar
  • Vascular lesions: Cherry angioma, infantile hemangioma, purpura, and telangiectasias – which ones are harmless dots and which should make you think platelets or systemic disease
  • Benign soft tissue growths: Lipoma vs epidermal inclusion cyst – the "soft, rubbery, freely mobile" mass patterns and why the central punctum matters
  • Chronic inflammatory lesions that mimic infection: Hidradenitis suppurativa – why recurrent "boils" in the axilla/groin aren't just another abscess

By the end, you'll be able to answer:

  • Recurrent abscesses in the axillae or groin – what diagnosis?
  • Rough, scaly, sandpaper‑like lesion on sun‑exposed skin – what diagnosis?
  • Waxy, stuck‑on pigmented lesion in an older adult – what diagnosis?

If you're working hard but your scores aren't reflecting it, that's not a character flaw, it's a systems problem. We fix that inside 33 Days to Pass the PANCE, where we train how you study, how you approach questions, and how you manage yourself on exam day so your effort actually shows up as points

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Physician Assistant Exam Review PodcastBy Brian Wallace