Pediatric Dermatology Basics — MCQs
Which type of dermatitis is evaluated through patch testing?
Café au lait spots are seen in which condition?
An eleven-year-old boy has Tinea capitis on his scalp. Which of the following is the most appropriate line of treatment for this condition?
Erythematous blotchy rash is seen on the abdomen, trunk, and face of a 3-day-old child along with yellowish papules. The child appears well. What is the appropriate management?
At what age can children typically draw a square?
What are the reading and writing skills of a child with moderate intellectual disability?
The burrow in scabies is in
The following image shows a flaccid bulla. This finding is characteristically seen in:
Cutis marmorata occurs due to exposure to –
Potato nose is seen in ?
Pediatric Dermatology Basics Indian Medical PG Practice Questions and MCQs
Question 1: Which type of dermatitis is evaluated through patch testing?
- A. Atopic dermatitis
- B. Irritant contact dermatitis
- C. Discoid eczema
- D. Contact dermatitis due to allergens (Correct Answer)
Explanation: ***Contact dermatitis due to allergens*** - **Patch testing** is specifically used to identify specific **allergens** that trigger an **allergic contact dermatitis** reaction. - It involves applying suspected allergens to the skin and observing for a localized inflammatory response, indicating delayed type IV hypersensitivity. *Atopic dermatitis* - This is a chronic inflammatory skin condition characterized by **eczematous lesions** and severe **pruritus**, often linked to a genetic predisposition and immune dysfunction. - While allergy testing (e.g., prick tests, blood tests for IgE) might be used to identify triggers, **patch testing** is not the primary diagnostic tool for atopic dermatitis itself. *Irritant contact dermatitis* - This type of dermatitis is caused by direct **damage to the skin barrier** from exposure to caustic substances or irritants, not an immune-mediated allergic reaction. - Diagnosis is usually based on clinical history of exposure and symptom presentation, and **patch testing** is typically negative in these cases. *Discoid eczema* - Also known as **nummular dermatitis**, this condition presents with distinctive **coin-shaped lesions** and is often associated with dry skin or skin trauma. - Its etiology is generally unknown and not attributable to specific allergens detectable by **patch testing**.
Question 2: Café au lait spots are seen in which condition?
- A. Cockayne syndrome
- B. Down syndrome
- C. Neurofibromatosis (Correct Answer)
- D. Gardner's syndrome
Explanation: ***Neurofibromatosis*** - **Café au lait spots** (light brown macules) are a hallmark feature of **Neurofibromatosis type 1 (NF1)**, often appearing in childhood. - Diagnosis of NF1 usually requires having **six or more café au lait spots** larger than 5 mm in prepubertal children or 15 mm in postpubertal individuals. *Cockayne syndrome* - This is a rare genetic disorder characterized by **premature aging**, **photosensitivity**, and **neurological dysfunction**, but not café au lait spots. - Key features include **dwarfism**, a "bird-like" facial appearance, and **progressive neurological degeneration**. *Down syndrome* - Caused by trisomy of chromosome 21, **Down syndrome** presents with distinct facial features like an upward slant to the eyes and a single palmar crease. - While it can be associated with various medical conditions, **café au lait spots** are not a characteristic finding. *Gardner's syndrome* - This is a subtype of **familial adenomatous polyposis** characterized by numerous **colorectal polyps**, alongside extracolonic manifestations such as **osteomas** and **desmoid tumors**. - **Pigmented lesions** can occur, but these are typically **retinal pigmented epithelial hypertrophy** or epidermal cysts, rather than café au lait spots.
Question 3: An eleven-year-old boy has Tinea capitis on his scalp. Which of the following is the most appropriate line of treatment for this condition?
- A. Shaving of the scalp
- B. Topical griseofulvin therapy
- C. Oral griseofulvin therapy (Correct Answer)
- D. Selenium sulphide shampoo
Explanation: ***Oral griseofulvin therapy*** - **Systemic antifungal agents** are essential for treating **Tinea capitis**, as the fungal infection is deep within the hair follicles and cannot be reached effectively by topical treatments alone. - **Griseofulvin** is a well-established and effective oral antifungal for **Tinea capitis** in children. *Shaving of the scalp* - While shaving the scalp might reduce some fungal load and facilitate topical treatment, it is **not a definitive treatment** for **Tinea capitis** on its own, as the infection remains deep in the hair follicles. - It does not address the underlying systemic nature of the infection within the hair shaft. *Topical griseofulvin therapy* - **Topical griseofulvin** is generally **ineffective** for **Tinea capitis** because the fungus resides deep within the hair follicle and hair shaft, where topical preparations cannot penetrate sufficiently. - **Systemic absorption** is required to deliver adequate drug concentrations to the site of infection. *Selenium sulphide shampoo* - **Selenium sulfide shampoo** can be used as an **adjunctive therapy** to reduce shedding of spores and prevent spread, but it is **not curative** for **Tinea capitis**. - It helps to reduce skin scaling and fungal burden on the surface but does not eradicate the infection deep within the hair follicles.
Question 4: Erythematous blotchy rash is seen on the abdomen, trunk, and face of a 3-day-old child along with yellowish papules. The child appears well. What is the appropriate management?
- A. Topical steroid and antibiotic lotion
- B. Topical steroid cream
- C. Intravenous antibiotics
- D. No treatment (Correct Answer)
Explanation: ***No treatment (Correct Answer)*** The described symptoms—erythematous blotchy rash with yellowish papules on the abdomen, trunk, and face in a well-appearing 3-day-old neonate—are **classic for erythema toxicum neonatorum**. **Key Features:** - **Benign, self-limiting rash** of unknown etiology - Affects **50-70% of term newborns** - Typically appears on **days 2-5** of life - Characterized by **erythematous macules/patches** with overlying **yellowish-white papules/pustules** - Infant appears **well and thriving** - **Resolves spontaneously** within 1-2 weeks without treatment - Histology shows **eosinophils** in pustules **Management:** Reassurance to parents; no medical intervention required. --- *Topical steroid and antibiotic lotion (Incorrect)* This approach is inappropriate because erythema toxicum neonatorum is: - **Not an infection** (no bacterial or fungal cause) - **Not an inflammatory condition** requiring steroids - Misdiagnosis and overtreatment could lead to unnecessary side effects, antibiotic resistance, and mask other conditions --- *Topical steroid cream (Incorrect)* Topical steroids are: - **Unnecessary** for this benign, self-resolving condition - **Potentially harmful** in neonates (can cause skin atrophy, increased absorption) - Provide **no therapeutic benefit** for erythema toxicum neonatorum --- *Intravenous antibiotics (Incorrect)* Systemic antibiotics are: - **Entirely unwarranted** as this is a non-infectious, benign rash - Would represent **gross overtreatment** with significant risks - Contribute to **antibiotic resistance** - Carry risks of adverse reactions, disruption of normal flora, and unnecessary hospitalization **Differentials to consider (but not present here):** - Transient neonatal pustular melanosis (present at birth) - Neonatal acne (appears later, at 2-4 weeks) - Miliaria (smaller, clear vesicles) - Infectious causes (infant appears ill, requires septic workup)
Question 5: At what age can children typically draw a square?
- A. 5 years (Correct Answer)
- B. 3 years
- C. 6 years
- D. 7 years
Explanation: ***5 years*** - At 5 years old, children have developed the **fine motor skills** and **cognitive abilities** necessary to copy and draw a square independently. - This is a key developmental milestone reflecting improved **visual-motor coordination** and understanding of geometric shapes with corners and angles. - By this age, children can also draw recognizable human figures with multiple body parts. *3 years* - While 3-year-olds can copy a circle and draw vertical/horizontal lines, they typically lack the **fine motor precision** and spatial understanding to draw a square with four equal sides and right angles. - Their drawings of angular shapes are crude approximations or scribbles rather than recognizable squares. *6 years* - By 6 years of age, children are proficient at drawing squares and other basic shapes, and are beginning to draw more complex figures with **perspective** and greater detail. - This age represents refinement beyond the initial mastery of drawing a square, which typically occurs at 5 years. *7 years* - At 7 years old, children have long mastered drawing basic shapes like squares and are capable of drawing objects with **depth and perspective** using multiple shapes, lines, and colors. - They demonstrate more advanced artistic expression and detailed representations.
Question 6: What are the reading and writing skills of a child with moderate intellectual disability?
- A. Basic (Correct Answer)
- B. Reasonable
- C. Minimal
- D. None
Explanation: ***Basic*** - Children with **moderate intellectual disability** can often achieve **basic reading and writing skills**, such as recognizing simple words and writing their name. - This level of skill might allow them to understand **simple written instructions** or basic functional communication. *Reasonable* - **"Reasonable"** reading and writing skills would imply a level of proficiency typically seen in individuals without intellectual disabilities or those with very mild forms, which is beyond the expected capabilities for **moderate intellectual disability**. - This term is **too vague** and generally implies a higher level of comprehension and expression than is characteristic of moderate intellectual impairment. *Minimal* - While their skills are limited, "minimal" often suggests an **even lower level of ability** — perhaps only recognizing a few letters or symbols. - Children with moderate intellectual disability can typically progress beyond this to acquiring a **functional basic literacy**. *None* - Stating "none" would be inaccurate, as most individuals with **moderate intellectual disability** are capable of acquiring some level of **functional literacy**, even if it is very basic. - Total absence of reading and writing skills is more commonly associated with **severe or profound intellectual disability**.
Question 7: The burrow in scabies is in
- A. S. corneum (Correct Answer)
- B. Malpighian layer
- C. S. germinatum
- D. S. granulosum
Explanation: ***S. corneum*** - The **burrow** created by the *Sarcoptes scabiei* mite is specifically found within the **stratum corneum** of the epidermis. - This superficial location allows the mite to feed on **keratinocytes** and deposit eggs, leading to the characteristic rash and intense itching. - The burrow appears as a **serpiginous tract** and is a pathognomonic finding in scabies. *Malpighian layer* - The **Malpighian layer** encompasses the **stratum basale** and **stratum spinosum**, which are deeper layers of the epidermis. - The scabies mite does not burrow into these deeper, metabolically active layers. *S. germinatum* - **Stratum germinativum** is another term for the **stratum basale**, the deepest epidermal layer responsible for cell division. - The scabies mite creates burrows at a much more superficial level in the stratum corneum. *S. granulosum* - The **stratum granulosum** lies between the stratum spinosum and stratum corneum. - While closer to the surface than the Malpighian layer, scabies burrows are specifically located in the more superficial **stratum corneum**, not the granulosum layer.
Question 8: The following image shows a flaccid bulla. This finding is characteristically seen in:
- A. Pemphigus vegetans
- B. Pemphigus vulgaris (Correct Answer)
- C. Pemphigus erythematosus
- D. Bullous pemphigoid
Explanation: ***Pemphigus vulgaris*** - The image shows a **flaccid bulla** with purulent fluid, characteristic of **pemphigus vulgaris**. This condition is marked by autoantibodies against desmogleins 1 and 3, which are crucial for keratinocyte adhesion, leading to **intraepidermal blistering** and the **Nikolsky sign**. - The flaccid nature of the bulla, often leading to easy rupture and erosions, is a hallmark of superficial blistering in pemphigus vulgaris, caused by the **loss of cell-to-cell adhesion** within the epidermis. *Pemphigus vegetans* - This is a rare variant of pemphigus vulgaris characterized by **vegetating plaques** and **hyperkeratotic lesions**, particularly in intertriginous areas. - While it starts with bullae, the predominant feature is the development of fungating, vegetative lesions rather than the flaccid bulla seen here. *Pemphigus erythematosus* - Pemphigus erythematosus, also known as Senear-Usher syndrome, is considered a localized form of pemphigus foliaceus with features of **lupus erythematosus**. - It presents with **scaling, crusting, and erythematous lesions** resembling lupus, along with superficial bullae, typically on the face and scalp. *Bullous pemphigoid* - Bullous pemphigoid typically presents with **tense bullae** that are less prone to rupture, unlike the flaccid bulla shown in the image. - It is caused by autoantibodies against hemidesmosomal proteins (BP180 and BP230), resulting in **subepidermal blistering**, meaning the blister forms below the epidermis and is therefore more resilient.
Question 9: Cutis marmorata occurs due to exposure to –
- A. Cold temperature (Correct Answer)
- B. Dust
- C. Hot temperature
- D. Humidity
Explanation: ***Cold temperature*** - **Cutis marmorata** is a physiological response to **cold temperatures**, characterized by a mottled, reticulated vascular pattern on the skin. - This occurs due to **vasoconstriction** of the small arteries and arterioles, alongside **vasodilation** of the venules, creating the characteristic marbled appearance. *Dust* - Exposure to **dust** typically causes **irritation**, allergic reactions, or respiratory issues, such as **dermatitis**, **contact urticaria**, or **asthma**. - It does not directly lead to the characteristic vascular changes seen in cutis marmorata. *Hot temperature* - **Hot temperatures** generally cause **vasodilation** in the skin to facilitate **heat dissipation**, leading to redness and warmth. - This is the opposite physiological response to cutis marmorata, which involves vasoconstriction. *Humidity* - **Humidity** primarily affects **skin hydration** and the rate of perspiration, potentially exacerbating certain skin conditions like **eczema** or **fungal infections**. - High or low humidity does not directly induce the vascular changes that result in cutis marmorata.
Question 10: Potato nose is seen in ?
- A. Acne vulgaris
- B. Rhinosporoidosis
- C. Acne rosacea (Correct Answer)
- D. Lupus vulgaris
Explanation: ***Acne rosacea*** - **Potato nose**, also known as **rhinophyma**, is a severe manifestation of **acne rosacea**, characterized by thickened, red, and bumpy skin on the nose. - This condition results from **hyperplasia of sebaceous glands** and connective tissue in the nose, leading to its characteristic bulbous appearance. *Acne vulgaris* - This common skin condition is characterized by **comedones**, **papules**, **pustules**, and sometimes cysts, primarily on the face, chest, and back. - It does **not typically cause rhinophyma** or significant thickening of nasal skin. *Rhinosporoidosis* - This is a **chronic granulomatous fungal infection** affecting mucous membranes, particularly the nose. - While it can cause nasal polyps and masses, it does **not result in the sebaceous gland hyperplasia** and thickened skin characteristic of rhinophyma. *Lupus vulgaris* - Lupus vulgaris is a chronic and progressive form of **cutaneous tuberculosis**, often affecting the face. - It presents with **reddish-brown plaques** and nodules that can ulcerate and scar but does **not lead to the specific nasal hypertrophy** seen in rhinophyma.
Want unlimited practice?
Get full access to all questions, explanations, and performance tracking.
Start For Free