Acne and Related Disorders — MCQs

Acne and Related Disorders Indian Medical PG Practice Questions and MCQs

Question 91: A key distinguishing feature of acne rosacea from acne vulgaris is:

A. Pustule
B. Erythema
C. Papule
D. Absence of comedone (Correct Answer)

Explanation: ***Absence of comedone*** - A key distinguishing feature is the **absence of comedones** (blackheads and whiteheads) in **acne rosacea**, which are characteristic of acne vulgaris. - Rosacea primarily involves **erythema**, telangiectasias, papules, and pustules, often triggered by factors like heat and stress. *Pustule* - While **pustules** can be present in both conditions, they are **more common** and often more inflammatory in acne vulgaris. - In rosacea, pustules often occur on an **erythematous** background without comedones. *Erythema* - **Erythema** (redness) is a prominent feature of **acne rosacea**, particularly central facial erythema, which is less pronounced and less persistent in acne vulgaris. - In rosacea, erythema is often accompanied by **telangiectasias** (visible blood vessels) and flushing. *Papule* - **Papules** are seen in both conditions, but in **acne rosacea**, they tend to be inflammatory and occur without associated comedones. - In acne vulgaris, papules often arise from inflamed **comedones** and can be accompanied by cysts and nodules.

Question 92: Which hormone is primarily associated with the development of acne?

A. Estrogen
B. Thyroid hormone
C. Testosterone (Correct Answer)
D. Gonadotropins

Explanation: ***Testosterone*** - **Androgens**, including **testosterone** and its more potent derivative **dihydrotestosterone (DHT)**, play a crucial role in acne development by stimulating the **sebaceous glands** to produce more **sebum**. - Increased sebum production, along with follicular hyperkeratinization and bacterial colonization, leads to the formation of **comedones** and inflammatory lesions characteristic of acne. *Estrogen* - **Estrogen** generally has an **anti-androgenic effect** and can reduce sebum production. - High estrogen levels, such as during pregnancy or with hormonal birth control, often lead to an improvement in acne. *Thyroid* - **Thyroid hormones** (T3 and T4) are primarily involved in regulating metabolism and growth. - While thyroid dysfunction can affect skin health, it is **not directly associated** with the primary pathogenesis of acne. *Gonadotropins* - **Gonadotropins** (FSH and LH) regulate the function of the ovaries and testes, including the production of sex hormones. - They indirectly influence hormone levels, but their direct role in the development of acne is **not primary**; rather, the downstream effects of the sex hormones they regulate (like testosterone) are more directly involved.

Question 93: What is the condition characterized by the hypertrophy of sebaceous glands?

A. Rhinosporidiosis
B. Tubercular infection
C. Sebaceous hyperplasia (Correct Answer)
D. Nasopharyngeal angiofibroma

Explanation: ***Sebaceous hyperplasia*** - This condition is characterized by the **enlargement (hypertrophy)** of normal sebaceous glands, often appearing as yellowish-white papules with a central umbilication. - It commonly occurs on the **face of older adults**, particularly on the forehead and cheeks, and is a benign condition. *Rhinosporidiosis* - This is a **chronic granulomatous disease** caused by the fungus *Rhinosporidium seeberi*, primarily affecting the **mucous membranes** of the nose and nasopharynx. - It presents as **friable, polypoidal masses** with a characteristic "strawberry-like" appearance due to small white spots (sporangia), not sebaceous gland hypertrophy. *Tubercular infection* - A tubercular infection, particularly cutaneous tuberculosis, can manifest in various forms, including **lupus vulgaris**, scrofuloderma, or tuberculosis cutis verrucosa. - These presentations involve **granulomatous inflammation** and tissue destruction, not isolated hypertrophy of sebaceous glands. *Nasopharyngeal angiofibroma* - This is a **rare, benign, highly vascular tumor** that originates in the nasopharynx, predominantly affecting adolescent males. - It typically presents with symptoms like **epistaxis** and **nasal obstruction**, and is composed of fibrous and vascular tissue, not sebaceous glands.

Question 94: Which of the following statements is true about rhinophyma?

A. Premalignant
B. Common in alcoholics
C. Acne rosacea (Correct Answer)
D. Fungal etiology

Explanation: ***Acne rosacea*** - **Rhinophyma** is a severe form of **acne rosacea**, characterized by sebaceous gland hypertrophy and connective tissue hyperplasia on the nose. - It specifically represents the **phymatous subtype** of rosacea, which involves thickening of the skin. *Premalignant* - Rhinophyma itself is generally **not considered premalignant** to skin cancer. - While skin cancers like **basal cell carcinoma** can rarely occur within rhinophyma, the condition itself does not inherently transform into malignancy. *Common in alcoholics* - This is a **common misconception**; while often associated with heavy alcohol use, there is no direct causal link. - The development of rhinophyma is primarily driven by the underlying pathogenesis of **rosacea**, not alcohol consumption. *Fungal etiology* - Rhinophyma is primarily an inflammatory skin condition, not caused by **fungal infection**. - Its etiology is complex, involving genetics, environmental triggers, and vascular dysregulation, but **microbial involvement** is typically bacterial (e.g., Demodex mites) rather than fungal.

Question 95: Which of the following is not a feature of rosacea?

A. Flushing
B. Telangiectasia
C. Mucosal ulcerations (Correct Answer)
D. Rhinophyma

Explanation: ***Mucosal ulcerations*** - **Mucosal ulcerations** are not a characteristic feature of rosacea; rosacea primarily affects the **facial skin**. - Conditions like **Behçet's disease** or **Crohn's disease** are associated with oral or genital mucosal ulcerations, not rosacea. *Flushing* - **Transient facial erythema (flushing)** is a hallmark symptom of rosacea, often triggered by heat, stress, or certain foods. - It is one of the primary diagnostic criteria and often the first symptom to appear. *Telangiectasia* - **Telangiectasias**, or visible small blood vessels, are a common and persistent feature of rosacea, especially in the **erythematotelangiectatic subtype**. - They result from chronic vasodilation and inflammation associated with the condition. *Rhinophyma* - **Rhinophyma**, characterized by skin thickening and irregular nodularity of the nose, is a severe form of **phymatous rosacea**. - While less common, it is a well-recognized and specific manifestation of advanced rosacea.

Question 96: Rhinophyma is associated with which of the following?

A. Hypertrophy of sebaceous gland (Correct Answer)
B. Infection of hair follicles
C. Congenital deformity of the nose
D. Hypertrophy of sweat gland

Explanation: ***Hypertrophy of sebaceous gland*** - **Rhinophyma** is a **chronic inflammatory skin condition** characterized by progressive enlargement and redness of the nose, primarily due to **hypertrophy of the sebaceous glands**. - It is considered a severe manifestation of **rosacea**, where the glandular and connective tissues become hyperplastic, leading to a bulbous, disfigured appearance. *Infection of hair follicles* - Infections of hair follicles, such as **folliculitis** or **furuncles (boils)**, are acute inflammatory conditions caused by bacteria or fungi. - While these can cause swelling and redness, they do not result in the chronic, progressive sebaceous gland hypertrophy seen in rhinophyma. *Congenital deformity of the nose* - **Congenital deformities** are structural abnormalities present at birth, often due to developmental errors during gestation. - Rhinophyma is an **acquired condition** that develops later in life, typically in adults, and is not present from birth. *Hypertrophy of sweat gland* - **Hypertrophy of sweat glands** (eccrine or apocrine) is not the characteristic feature of rhinophyma. - Conditions involving sweat gland overgrowth are rare and present differently, such as in certain forms of **hidradenitis** or **cystic fibrosis**, and do not lead to the specific nasal disfigurement of rhinophyma.

Question 97: Benzoyl peroxide acts in acne vulgaris by:

A. Decreasing bacterial count (Correct Answer)
B. Reduces sebum production
C. Acts as a keratolytic agent
D. Increases epithelial turnover

Explanation: ***Decreasing bacterial count*** - **Benzoyl peroxide** is a highly effective topical treatment for acne primarily due to its potent **antimicrobial activity** against *Cutibacterium acnes*, the bacterium implicated in acne pathogenesis. - It works by releasing **free radicals** that disrupt bacterial cell membranes and metabolism, thereby reducing the bacterial load in follicles. *Reduces sebum production* - While sebaceous gland activity is critical in acne, benzoyl peroxide does **not directly reduce sebum production**; retinoids like isotretinoin are known for this effect. - Its primary action is focused on combating bacteria and mildly promoting desquamation rather than affecting **lipid synthesis**. *Acts as a keratolytic agent* - Benzoyl peroxide does possess some **keratolytic activity**, aiding in the shedding of dead skin cells and preventing pore blockage. - However, its keratolytic action is **less pronounced** compared to agents like salicylic acid or tretinoin, and it is not its primary mechanism of action. *Increases epithelial turnover* - While benzoyl peroxide does promote a mild increase in **epithelial cell turnover**, helping to clear clogged pores, it is not its main mechanism of action or defining characteristic. - **Topical retinoids** (e.g., tretinoin, adapalene) are far more effective and primarily used to normalize follicular keratinization and increase cell turnover.

Practice by Chapter

Acne Vulgaris: Pathophysiology

Practice Questions

Acne Vulgaris: Clinical Types

Practice Questions

Acne Vulgaris: Management

Practice Questions

Acne in Special Populations

Practice Questions

Rosacea

Practice Questions

Perioral Dermatitis

Practice Questions

Hidradenitis Suppurativa

Practice Questions

Acne Keloidalis Nuchae

Practice Questions

Acne Scarring and Its Management

Practice Questions

Psychological Aspects of Acne

Practice Questions

Diet and Acne

Practice Questions

Newer Therapies in Acne Management

Practice Questions

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