FMGE 2019 — Dermatology

Q: What is the name of this appearance which is seen in pellagra?

Casal's necklace. ***Casal's necklace*** - Characteristic of **pellagra**, it presents as a **dermatitis** localized around the neck in a "necklace" pattern due to **niacin deficiency**. - This sign is commonly associated with other symptoms of pellagra, such as **dermatitis**, **diarrhea**, and **dementia**. *Shawl sign* - This sign typically refers to **lupus erythematosus** and involves a **rash** on the shoulders, not associated with pellagra. - It is characterized by an **erythematous rash** in sun-exposed areas, distinct from the features of **pellagra**. *Gottron's papule* - These are **papules** seen in **dermatomyositis**, characterized by violaceous lesions on the fingers, not related to pellagra. - Their appearance is associated with **muscle weakness** and other features of dermatomyositis, rather than **niacin deficiency**. *Burn* - Refers to an injury from thermal exposure and does not relate to the **dermatological signs** of pellagra. - It is not a clinical feature and does not reflect the **nutritional deficiency** seen in this condition. [Practice more Dermatology PYQs on OnCourse]

Q: Rodent ulcer is

Basal cell carcinoma. ***Basal cell carcinoma*** - The term **"rodent ulcer"** is a historical and descriptive term for a specific type of **basal cell carcinoma (BCC)**, characterized by a **pearly raised border** and a central ulceration. - This appearance, with its rolled edges and sometimes visible telangiectasias, gives the impression of a lesion gnawing away at the tissue, hence the "rodent" description. *Squamous cell carcinoma* - While also a common skin cancer, **squamous cell carcinoma (SCC)** typically presents as a **scaly, crusted nodule or plaque** with irregular borders, or a non-healing ulcer that does not have the classic rolled border of a rodent ulcer. - It is more prone to **metastasis** than BCC. *Rhinophyma* - **Rhinophyma** is a severe form of **rosacea** that causes a bulbous, red, and swollen nose due to hyperplasia of sebaceous glands and connective tissue. - It is a **benign condition** and not a form of skin cancer or ulcer. *Adenocarcinoma (glandular cancer)* - **Adenocarcinoma** is a type of cancer that originates in **glandular tissue**, such as in the breast, prostate, colon, or lung. - It is **not a primary skin cancer** and does not typically present as a "rodent ulcer" on the skin surface. [Practice more Dermatology PYQs on OnCourse]

2 Previous Year Questions with Answers & Explanations

Questions

What is the name of this appearance which is seen in pellagra?

Rodent ulcer is

FMGE 2019 - Dermatology FMGE Practice Questions and MCQs

Question 1: What is the name of this appearance which is seen in pellagra?

A. Shawl sign
B. Casal's necklace (Correct Answer)
C. Gottron's papule
D. Burn

Explanation: ***Casal's necklace*** - Characteristic of **pellagra**, it presents as a **dermatitis** localized around the neck in a "necklace" pattern due to **niacin deficiency**. - This sign is commonly associated with other symptoms of pellagra, such as **dermatitis**, **diarrhea**, and **dementia**. *Shawl sign* - This sign typically refers to **lupus erythematosus** and involves a **rash** on the shoulders, not associated with pellagra. - It is characterized by an **erythematous rash** in sun-exposed areas, distinct from the features of **pellagra**. *Gottron's papule* - These are **papules** seen in **dermatomyositis**, characterized by violaceous lesions on the fingers, not related to pellagra. - Their appearance is associated with **muscle weakness** and other features of dermatomyositis, rather than **niacin deficiency**. *Burn* - Refers to an injury from thermal exposure and does not relate to the **dermatological signs** of pellagra. - It is not a clinical feature and does not reflect the **nutritional deficiency** seen in this condition.

Question 2: Rodent ulcer is

A. Squamous cell carcinoma
B. Basal cell carcinoma (Correct Answer)
C. Rhinophyma
D. Adenocarcinoma (glandular cancer)

Explanation: ***Basal cell carcinoma*** - The term **"rodent ulcer"** is a historical and descriptive term for a specific type of **basal cell carcinoma (BCC)**, characterized by a **pearly raised border** and a central ulceration. - This appearance, with its rolled edges and sometimes visible telangiectasias, gives the impression of a lesion gnawing away at the tissue, hence the "rodent" description. *Squamous cell carcinoma* - While also a common skin cancer, **squamous cell carcinoma (SCC)** typically presents as a **scaly, crusted nodule or plaque** with irregular borders, or a non-healing ulcer that does not have the classic rolled border of a rodent ulcer. - It is more prone to **metastasis** than BCC. *Rhinophyma* - **Rhinophyma** is a severe form of **rosacea** that causes a bulbous, red, and swollen nose due to hyperplasia of sebaceous glands and connective tissue. - It is a **benign condition** and not a form of skin cancer or ulcer. *Adenocarcinoma (glandular cancer)* - **Adenocarcinoma** is a type of cancer that originates in **glandular tissue**, such as in the breast, prostate, colon, or lung. - It is **not a primary skin cancer** and does not typically present as a "rodent ulcer" on the skin surface.