INI-CET 2023 - Dermatology PYQs Practice Questions

Q: Slapped cheek appearance is associated with which of the following?

Parvovirus B19 infection. ***Parvovirus B19 infection*** - **Parvovirus B19** infection, also known as Fifth Disease or **Erythema Infectiosum**, classically presents with a **slapped cheek rash** on the face. - This characteristic facial rash is usually followed by a **lacy, reticular rash** on the trunk and extremities. *Herpes zoster* - **Herpes zoster** (shingles) presents as a painful, vesicular rash that follows a **dermatomal distribution**. - It does not cause a **slapped cheek appearance**; its rash is typically unilateral and confined to a single dermatome. *Molluscum contagiosum* - **Molluscum contagiosum** is characterized by small, flesh-colored, **umbilicated papules** with a central dimple. - These lesions can occur anywhere on the body but do not produce a diffuse facial rash like the **slapped cheek appearance**. *Kaposi sarcoma* - **Kaposi sarcoma** is a vascular tumor that manifests as **purple, brown, or reddish skin lesions**, often seen in immunocompromised individuals. - It is not associated with a **widespread facial rash** or the characteristic distribution of a slapped cheek appearance. [Practice more Dermatology PYQs on OnCourse]

Q: A man presents with a rash on his flank with itching for the past 2 weeks. The patient has tried several over-the-counter medications, including lotrimin and hydrocortisone, without any improvement. In physical examination, the rash is seen on his palms and the sole of one foot, but no oral lesions are found. What is the likely diagnosis?

Secondary syphilis. ***Secondary syphilis*** - The rash presenting on the **palms and soles** is highly characteristic of **secondary syphilis**, which helps differentiate it from many other dermatological conditions. - The lack of improvement with antifungal (Lotrimin) and corticosteroid (hydrocortisone) treatments further supports a diagnosis other than a fungal infection or inflammatory dermatitis. *Tinea corporis* - This fungal infection typically presents as an **annular (ring-shaped) rash** with central clearing and well-demarcated borders, often on the trunk or limbs. - It would likely show some improvement, even if partial, with **Lotrimin (an antifungal medication)**, which is not the case here. *Pityriasis rosea* - This condition is characterized by an initial **"herald patch"** followed by smaller, oval, pinkish-red patches that often align along skin cleavage lines in a **"Christmas tree" pattern** on the trunk. - It typically spares the palms and soles, which are involved in this patient's presentation. *Contact dermatitis* - This is an inflammatory skin reaction due to contact with an allergen or irritant, presenting as **pruritic (itchy) erythematous (red) patches, possibly with vesicles or bullae**, limited to exposed areas. - While hydrocortisone might offer some relief, the presentation on palms and soles without clear exposure and the lack of response to treatment make it less likely. [Practice more Dermatology PYQs on OnCourse]

Q: Match the following woods lamp findings: 1. Erythrasma, 2. Pityriasis versicolor, 3. Tinea capitis, 4. Vitiligo || a. Yellow b. Coral red fluorescence c. Pink d. Green e. Milky white

1-b, 2-a, 3-d, 4-e. ***1-b, 2-a, 3-d, 4-e*** - **Erythrasma** is caused by *Corynebacterium minutissimum* and produces **porphyrins** that fluoresce **coral red** under a Wood's lamp [1]. - **Pityriasis versicolor** is caused by *Malassezia furfur* and typically fluoresces **yellow to yellowish-green** [2]. - **Tinea capitis** (especially due to *Microsporum* species) shows **green fluorescence** of infected hairs. - **Vitiligo** lesions, due to a complete absence of melanin, appear as **milky white** or bright white areas under a Wood's lamp [3]. *1-d, 2-a, 3-c, 4-e* - This option incorrectly states that Erythrasma fluoresces green. Green fluorescence is characteristic of *Microsporum* species causing **Tinea capitis**. - Additionally, Tinea capitis is incorrectly associated with pink fluorescence, which is not a typical finding. *1-a, 2-c, 3-e, 4-d* - This option incorrectly states that Erythrasma fluoresces yellow. Yellow fluorescence is associated with **Pityriasis versicolor** [2]. - It also incorrectly assigns milky white fluorescence to Tinea capitis and green fluorescence to Vitiligo. *1-b, 2-d, 3-a, 4-c* - This option incorrectly associates Pityriasis versicolor with green fluorescence. While some variations exist, **yellow** is the more characteristic finding [2]. - It also incorrectly links Tinea capitis to yellow fluorescence and Vitiligo to pink, which are not typical Wood's lamp findings for these conditions. [Practice more Dermatology PYQs on OnCourse]

Q: Non-scarring alopecia is associated with all except?

Frontal fibrosing alopecia. ***Frontal fibrosing alopecia*** - This condition is a form of **lichen planopilaris**, which causes **scarring alopecia** due to destruction of hair follicles and replacement with fibrous tissue. - It results in a **receding hairline** and eyebrow loss, with irreversible hair loss. *Telogen effluvium* - This is a common cause of **non-scarring alopecia**, characterized by diffuse hair shedding triggered by various stressors like illness, stress, or medications. - The hair follicles enter the **telogen phase** prematurely, leading to increased shedding but typically regrowth once the trigger is removed. *Androgenetic alopecia* - Often referred to as **male or female pattern baldness**, this is a form of **non-scarring alopecia** driven by genetic predisposition and androgens. - It causes a progressive miniaturization of hair follicles, leading to thinning hair, but the follicles remain present and capable of producing hair. *Alopecia areata* - This is an **autoimmune condition** that causes **non-scarring hair loss** in patches on the scalp or other parts of the body. - The hair follicles are attacked by the immune system but are not permanently destroyed, allowing for potential regrowth. [Practice more Dermatology PYQs on OnCourse]

Q: A 24-year-old male presents with asymptomatic scaly lesions over the body as shown in the image below. What is the likely diagnosis?

Pityriasis Rosea. ***Pityriasis Rosea*** - The image shows numerous **scaly, erythematous plaques** distributed over the trunk, with a characteristic "Christmas tree" pattern often observed in Pityriasis Rosea. - The lesions are described as **asymptomatic**, which is consistent with Pityriasis Rosea, although mild pruritus can occur. *Atopic Dermatitis* - Typically presents with **intensely pruritic, erythematous, and eczematous lesions** often found in flexural areas (e.g., antecubital and popliteal fossae). - While it can be widespread, the morphology of the lesions (eczematous vs. scaly plaques) and the absence of pruritus make this less likely. *Lichen planus* - Characterized by **pruritic, violaceous, polygonal papules** and plaques, often appearing on the flexor surfaces of wrists, ankles, and oral mucosa. - The appearance of the lesions in the image does not match the typical morphology of lichen planus. *Seborrheic Dermatitis* - Primarily affects areas with a high density of sebaceous glands, such as the **scalp, face (nasolabial folds, eyebrows), and chest**. - Presents with **greasy, yellowish scales** on an erythematous base, which is distinct from the dry, scaly plaques seen in the image. [Practice more Dermatology PYQs on OnCourse]

Question 1

Slapped cheek appearance is associated with which of the following?

Accepted Answer

Parvovirus B19 infection

Answer

Herpes zoster

Answer

Molluscum contagiosum

Answer

Kaposi sarcoma

Question 2

A man presents with a rash on his flank with itching for the past 2 weeks. The patient has tried several over-the-counter medications, including lotrimin and hydrocortisone, without any improvement. In physical examination, the rash is seen on his palms and the sole of one foot, but no oral lesions are found. What is the likely diagnosis?

Accepted Answer

Secondary syphilis

Answer

Tinea corporis

Answer

Pityriasis rosea

Answer

Contact dermatitis

Question 3

Match the following woods lamp findings: 1. Erythrasma, 2. Pityriasis versicolor, 3. Tinea capitis, 4. Vitiligo || a. Yellow  b. Coral red fluorescence c. Pink  d. Green e. Milky white

Accepted Answer

1-b, 2-a, 3-d, 4-e

Answer

1-d, 2-a, 3-c, 4-e

Answer

1-a, 2-c, 3-e, 4-d

Answer

1-b, 2-d, 3-a, 4-c

Question 4

Non-scarring alopecia is associated with all except?

Accepted Answer

Frontal fibrosing alopecia

Answer

Telogen effluvium

Answer

Androgenetic alopecia

Answer

Alopecia areata

Question 5

A 24-year-old male presents with asymptomatic scaly lesions over the body as shown in the image below. What is the likely diagnosis?

Accepted Answer

Pityriasis Rosea

Answer

Atopic Dermatitis

Answer

Lichen planus

Answer

Seborrheic Dermatitis

Question 6

Statement 1 - A 59-year-old patient presents with flaccid bullae. Histopathology shows a suprabasal acantholytic split.
Statement 2 - The row of tombstones appearance is diagnostic of Pemphigus vulgaris.

Accepted Answer

Statements 1 & 2 are correct, 2 is not explaining 1

Answer

Statements 1 and 2 are correct and 2 is the correct explanation for 1

Answer

Statements 1 and 2 are incorrect

Answer

Statement 1 is incorrect

Question 7

A 60-year-old female presents with eczematous itching lesions. Biopsy revealed a subepidermal cleft with Direct Immunofluorescence showing Linear C3 & IgG deposition along the basement membrane zone. What is the likely diagnosis?

Accepted Answer

Bullous Pemphigoid

Answer

Pemphigus foliaceus

Answer

Pemphigus Vulgaris

Answer

Dermatitis herpetiformis

INI-CET 2023 — Dermatology