Basic Dermatology Practice Questions

Q: All are causes of the skin lesion shown except:

Chronic renal failure. ***Chronic renal failure*** - The image depicts **erythema multiforme**, a hypersensitivity reaction characterized by **target lesions**. - **Chronic renal failure** is not a known direct cause of erythema multiforme. *Infectious mononucleosis* - **Viral infections**, including **Epstein-Barr virus** (which causes infectious mononucleosis), are common triggers for erythema multiforme. - The immune response to the viral infection can lead to the characteristic skin lesions. *Mycoplasma* - **Mycoplasma pneumoniae infection** is a well-established cause of erythema multiforme, particularly in children and young adults. - Mycoplasma is one of the most common infectious triggers and can also cause other severe mucocutaneous reactions. *Collagen vascular disease* - Certain **collagen vascular diseases**, such as **systemic lupus erythematosus**, can be associated with erythema multiforme. - The underlying autoimmune dysregulation can trigger generalized hypersensitivity reactions.

Q: Pseudo Nikolsky sign is seen in all except:

Erythema Multiforme. ***Erythema Multiforme*** - Erythema multiforme is an acute, self-limiting inflammatory dermatosis, and it typically does not present with a **Pseudo Nikolsky sign** as its lesions are usually fixed or have minimal epidermal involvement. - The disease is characterized by target lesions, often in response to infections (e.g., herpes simplex virus) or drugs, with **subepidermal blistering** in some cases but usually without extensive epidermal detachment. *Toxic epidermal Necrolysis* - **Toxic epidermal Necrolysis (TEN)** is a severe mucocutaneous reaction characterized by widespread **epidermal detachment**, making the Nikolsky sign and Pseudo Nikolsky sign positive due to extensive skin fragility and epidermal loss. - This condition involves full-thickness epidermal necrosis, leading to blistering and sloughing of skin that resembles a **severe burn**. *Stevens Johnson Syndrome* - **Stevens-Johnson Syndrome (SJS)** is a less severe form of TEN, but it also features **epidermal detachment** and usually has a positive Nikolsky sign, and therefore also a Pseudo Nikolsky sign. - It involves smaller body surface area detachment compared to TEN but still demonstrates significant epidermal damage and skin fragility. *Staphylococcal scalded skin syndrome* - In **Staphylococcal scalded skin syndrome (SSSS)**, toxins produced by *Staphylococcus aureus* specifically target **desmoglein-1**, causing superficial epidermal splitting and a prominent positive Nikolsky sign (and Pseudo Nikolsky sign). - This condition results in widespread **flaccid blisters** and exfoliation, particularly in children, without full-thickness epidermal necrosis.

Q: The following skin condition is associated with:

Diabetes. ***Diabetes*** - The image displays characteristics of **necrobiosis lipoidica**, a skin condition strongly associated with **diabetes mellitus**. - Necrobiosis lipoidica typically presents as **shiny, atrophic plaques with distinct red or violaceous borders and a yellow-brown center**, often on the shins, as seen in the image. *Hyperthyroidism* - This condition is associated with **pretibial myxedema**, which presents as non-pitting edema and thickened, discolored skin, distinct from the atrophic plaques shown. - Other dermatological manifestations include **onycholysis** (Plummer's nails), fine hair, and generalized hyperpigmentation, none of which are consistent with the image. *Hypothyroidism* - Hypothyroidism is associated with **generalized myxedema**, which results in dry, coarse, cold skin, and facial puffiness. - It does not typically cause the **atrophic, yellow-brown plaques** characteristic of the presented skin lesion. *Sarcoidosis* - Sarcoidosis can cause various skin lesions, including **erythema nodosum**, lupus pernio, and subcutaneous nodules. - These lesions have distinct appearances that do not match the **necrobiosis lipoidica** depicted in the image.

Q: The skin condition shown in the image is associated with?

Diabetes mellitus. ***Diabetes mellitus*** - The image shows **diabetic dermopathy** (also known as "shin spots"), which presents as hyperpigmented, atrophic macules or papules, usually on the shins. This condition is a common cutaneous manifestation of **diabetes mellitus**. - Other dermatological conditions associated with diabetes include **necrobiosis lipoidica diabeticorum**, **acanthosis nigricans**, and **erythrasma**, which are important to recognize in patients with diabetes. *Hypothyroidism* - Hypothyroidism is associated with **myxedema**, which typically manifests as non-pitting edema, dry and coarse skin, and hair loss. - While it can cause skin changes, it does not typically present with the pigmented, atrophic lesions seen in the image. *Hyperthyroidism* - Hyperthyroidism can cause skin changes such as **pretibial myxedema** (a specific form of localized skin thickening, typically on the shins, that is often associated with Graves' disease) and warm, moist skin due to increased metabolism. - The lesions shown in the image are not consistent with the typical presentation of pretibial myxedema or other hyperthyroid skin manifestations. *Sarcoidosis* - Sarcoidosis can present with various skin lesions, including **erythema nodosum**, lupus pernio, plaques, and papules. - The skin changes seen in the image, characterized by small, atrophic, hyperpigmented macules, do not fit the typical pattern of cutaneous sarcoidosis.

Q: The following image shows:

Wood's lamp. ***Wood's lamp*** - The image clearly displays a device with **ultraviolet (UV) light bulbs** (blue tubes) and a magnifying lens, which is characteristic of a Wood's lamp. - A Wood's lamp is used in dermatology to detect various skin conditions by observing the **fluorescence** of certain substances under UV light. *Infrared lamp* - An infrared lamp produces **heat** and is typically used for therapeutic purposes such as pain relief, not for diagnostic skin examination using UV fluorescence. - Its appearance would involve a bulb that emits visible red light and heat, not the distinct blue UV tubes seen here. *Slit lamp* - A slit lamp is a **biomicroscope** used in ophthalmology to examine the anterior segment and posterior segment of the human eye. - It consists of a light source that can be focused into a narrow slit and a binocular microscope, which looks completely different from the device pictured. *Thermoprobe* - A thermoprobe is a device used to measure **temperature**, often a small probe with a digital readout. - It has no magnifying capabilities or UV light sources, making it distinct from the instrument shown in the image.

Q: The following image shows:

Acantholytic cell. ***Acantholytic cell*** - The image displays characteristics of an **acantholytic cell**, particularly with its **rounder shape** and visible nucleus, surrounded by a distinct halo or separated from adjacent cells. - These cells result from the loss of cohesion between **keratinocytes** due to the breakdown of desmosomes, a hallmark feature in conditions like **Pemphigus vulgaris**. *Acanthocyte* - An **acanthocyte** is a red blood cell with **spiculated projections** (thorn-like processes) on its surface, often seen in liver disease or abetalipoproteinemia. - The cell in the image does not resemble a red blood cell and lacks the characteristic spiky projections. *Acanthosis* - **Acanthosis** refers to the **thickening of the stratum spinosum** (prickle cell layer) in the epidermis. - This is a **histopathological finding** visible at a tissue level, not a characteristic of an individual cell. *Anaplastic cell* - An **anaplastic cell** is typically a **highly undifferentiated malignant cell** with features like pleomorphism, prominent nucleoli, and abnormal mitotic figures. - While these cells can be irregular, the cell in the image specifically points to loss of intercellular adhesion rather than general cellular malignancy and dedifferentiation.

Q: The image shows a child with?

Ehlers-Danlos syndrome. ***Ehlers-Danlos syndrome*** - The image demonstrates extreme **skin hyperextensibility**, a hallmark feature of **Ehlers-Danlos syndrome** (EDS), a group of inherited connective tissue disorders. - This unusual elasticity is due to defects in **collagen synthesis** or processing, leading to fragile and hyperelastic skin. *Cutis laxa* - Characterized by **loose, sagging, and inelastic skin** that hangs in folds, giving a prematurely aged appearance, which is different from the extreme stretchiness seen in the image. - The skin in cutis laxa appears "too large for the body" and does not recoil quickly after stretching. *Marfan syndrome* - Primarily affects the skeletal, ocular, and cardiovascular systems, presenting with features like **tall stature, long limbs and fingers (arachnodactyly)**, and lens dislocation. - While it is a connective tissue disorder, **skin hyperextensibility** is not a prominent or diagnostic feature of Marfan syndrome. *Ataxia-telangiectasia* - A rare, neurodegenerative, inherited disease characterized by **progressive cerebellar ataxia**, **oculocutaneous telangiectasias**, and immunodeficiency. - Skin elasticity is not affected, and the clinical presentation is dominated by neurological symptoms and recurrent infections.

Q: A 30-year-old woman presents with a cosmetic complaint shown in the image. What is the clinical diagnosis?

Xanthelasma. ***Xanthelasma*** - The image shows **yellowish, plaque-like lesions** on the **eyelids**, which are characteristic of xanthelasma. These lesions are **deposits of cholesterol** within macrophages in the skin. - Xanthelasma is often associated with **dyslipidemia**, though it can also occur in individuals with normal lipid levels. *Necrobiosis lipoidica* - This condition typically presents as **sharply demarcated, yellowish-brown plaques** with an atrophic, waxy center, often on the **shins**. - It is frequently associated with **diabetes mellitus** and does not typically involve the eyelids in this manner. *Tuberous xanthoma* - Tuberous xanthomas are **firm, painless nodules** that typically appear over **extensor surfaces** such as elbows, knees, and Achilles tendons. - They are also fat deposits but differ in morphology and location from the eyelid lesions seen here. *Orbital lipogranuloma* - An orbital lipogranuloma is an **inflammatory mass within the orbit** that can cause proptosis or swelling around the eye. - It is an internal orbital mass, not a superficial skin lesion on the eyelids as depicted.

Q: All are causes of following tongue appearance except: (Recent NEET Pattem 2016-17)

HIV. ***HIV*** - The image shows a **fissured tongue**, which is characterized by **grooves and furrows** on the dorsal surface of the tongue. - While other conditions can cause a fissured tongue, **HIV** itself is *not* considered a direct cause of this specific tongue morphology. Oral manifestations of HIV typically include **candidiasis**, **hairy leukoplakia**, or Kaposi's sarcoma. *Melkersson-Rosenthal syndrome* - This syndrome is characterized by a triad of **relapsing facial paralysis**, **persistent orofacial swelling**, and a **fissured tongue**. - Therefore, a fissured tongue is a recognized clinical feature of Melkersson-Rosenthal syndrome. *Down syndrome* - Individuals with Down syndrome (Trisomy 21) frequently present with various oral manifestations, including a **fissured tongue** (also known as scrotal tongue or plicated tongue). - This is a common and characteristic finding in this genetic condition. *Genetic basis* - A **fissured tongue** can have a **genetic predisposition** and may occur as an isolated familial trait. - It can be inherited as an **autosomal dominant trait** and is often seen without any associated syndromic conditions.

Q: The image shows presence of:

Black hairy tongue. ***Black hairy tongue*** - The image clearly displays an elongated and discolored appearance of the **filiform papillae** on the dorsal surface of the tongue, consistent with **black hairy tongue**. - This condition is characterized by an accumulation of **keratin** and the overgrowth of bacteria or fungi, leading to the characteristic "hairy" and often discolored (dark brown to black) appearance. *Leukoplakia* - Leukoplakia typically presents as **white patches** or plaques on the mucous membranes that cannot be scraped off and are not attributable to any other disease. - Unlike the image, it does not involve the elongation of filiform papillae and generally lacks the "hairy" texture. *Geographical tongue* - **Geographical tongue**, also known as benign migratory glossitis, is characterized by migrating, irregularly shaped **red lesions** surrounded by raised white or yellowish borders. - These lesions represent areas of **atrophy of the filiform papillae** and appear smooth and depapillated, which is in contrast to the elongated papillae seen in the image. *Median rhomboid glossitis* - **Median rhomboid glossitis** is a well-demarcated, often **erythematous** (reddish) and sometimes lobulated or nodular lesion located in the **midline of the dorsal tongue**, anterior to the circumvallate papillae. - It is typically characterized by the **absence of filiform papillae** in the affected area, presenting a smooth or nodular surface, which differs from the widespread elongated papillae in the image.

Question 1

All are causes of the skin lesion shown except:

Accepted Answer

Chronic renal failure

Answer

Infectious mononucleosis

Answer

Mycoplasma

Answer

Collagen vascular disease

Question 2

Pseudo Nikolsky sign is seen in all except:

Accepted Answer

Erythema Multiforme

Answer

Toxic epidermal Necrolysis

Answer

Stevens Johnson Syndrome

Answer

Staphylococcal scalded skin syndrome

Question 3

The following skin condition is associated with:

Accepted Answer

Diabetes

Answer

Hyperthyroidism

Answer

Hypothyroidism

Answer

Sarcoidosis

Question 4

The skin condition shown in the image is associated with?

Accepted Answer

Diabetes mellitus

Answer

Hypothyroidism

Answer

Hyperthyroidism

Answer

Sarcoidosis

Question 5

The following image shows:

Accepted Answer

Wood's lamp

Answer

Infrared lamp

Answer

Slit lamp

Answer

Thermoprobe

Question 6

The following image shows:

Accepted Answer

Acantholytic cell

Answer

Acanthocyte

Answer

Acanthosis

Answer

Anaplastic cell

Question 7

The image shows a child with?

Accepted Answer

Ehlers-Danlos syndrome

Answer

Cutis laxa

Answer

Marfan syndrome

Answer

Ataxia-telangiectasia

Question 8

A 30-year-old woman presents with a cosmetic complaint shown in the image. What is the clinical diagnosis?

Accepted Answer

Xanthelasma

Answer

Necrobiosis lipoidica

Answer

Tuberous xanthoma

Answer

Orbital lipogranuloma

Question 9

All are causes of following tongue appearance except: (Recent NEET Pattem 2016-17)

Accepted Answer

HIV

Answer

Melkersson-Rosenthal syndrome

Answer

Down syndrome

Answer

Genetic basis

Question 10

The image shows presence of:

Accepted Answer

Black hairy tongue

Answer

Leukoplakia

Answer

Geographical tongue

Answer

Median rhomboid glossitis

Basic Dermatology — MCQs

Basic Dermatology — MCQs

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