Cosmetic Dermatology — MCQs

Cosmetic Dermatology Indian Medical PG Practice Questions and MCQs

Question 11: Berloque dermatitis is due to contact with which of the following?

A. Plants
B. Food
C. Cosmetics (Correct Answer)
D. Metal

Explanation: **Explanation:** **Berloque dermatitis** (also known as "pendant dermatitis") is a specific form of **Phytophotodermatitis**. It occurs due to the application of **cosmetics**, specifically perfumes or colognes containing **Bergamot oil** (derived from the rind of *Citrus bergamia*). 1. **Mechanism:** Bergamot oil contains **Bergapten (5-methoxypsoralen)**, a potent photosensitizer. When the perfume is applied to the skin (often the neck or wrists) and subsequently exposed to **Ultraviolet A (UVA)** light, a phototoxic reaction occurs. This results in acute erythema followed by characteristic "pendant-like" or "streak-like" hyperpigmentation. 2. **Why other options are incorrect:** * **Plants:** While many plants (like carrots, celery, or limes) cause phytophotodermatitis, the specific term "Berloque" is reserved for reactions caused by perfumes/cosmetics. * **Food:** Ingestion of specific foods does not cause this localized streak-like dermatitis. * **Metal:** Metal contact typically causes Allergic Contact Dermatitis (Type IV hypersensitivity), such as Nickel dermatitis, which does not require sunlight to manifest. **Clinical Pearls for NEET-PG:** * **Etiology:** 5-Methoxypsoralen (Bergapten) + UVA light. * **Clinical Feature:** Hyperpigmentation in the shape of perfume droplets or streaks (Berloque is French for "trinket" or "pendant"). * **Type of Reaction:** It is a **Phototoxic** reaction (non-immunologic), not photoallergic. * **Other related conditions:** *Dermatitis pratensis* (meadow grass dermatitis) is the plant-induced counterpart.

Question 12: A 30-year-old woman presents with a cosmetic complaint shown in the image. What is the clinical diagnosis?

A. Xanthelasma (Correct Answer)
B. Necrobiosis lipoidica
C. Tuberous xanthoma
D. Orbital lipogranuloma

Explanation: ***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.

Question 13: Which of the following statements about spider telangiectasia is false?

A. More common in males (Correct Answer)
B. Light therapy for treatment
C. May be associated with liver disease
D. Can be caused by trauma

Explanation: ***More common in males*** - This statement is **FALSE** because spider telangiectasias (spider nevi/spider angiomas) are more commonly observed in **females**, often due to hormonal influences like **estrogen**. - They are frequently associated with conditions such as **pregnancy**, **oral contraceptive use**, or **chronic liver disease**, highlighting a female predominance. - The estrogen-dependent nature explains their higher prevalence in women of reproductive age. *Can be caused by trauma* - This statement is **TRUE** in a broader sense, though classical spider telangiectasias are primarily hormonally-mediated rather than traumatic. - While **simple telangiectasias** can develop after localized trauma or repeated pressure, spider telangiectasias have a characteristic morphology (central arteriole with radiating vessels) and are typically associated with **estrogen excess** or **liver disease**. - For exam purposes, this is considered a true statement as telangiectatic vessels can be influenced by local factors. *Light therapy for treatment* - This statement is **TRUE**. **Laser therapy**, specifically **pulsed dye laser (PDL)** or **intense pulsed light (IPL)**, is the most effective treatment for spider telangiectasias. - The laser selectively targets **hemoglobin** in the dilated vessels, causing photocoagulation and vessel obliteration, leading to excellent cosmetic results. *May be associated with liver disease* - This statement is **TRUE**. Spider telangiectasias are a well-recognized cutaneous manifestation of **chronic liver disease**, especially **cirrhosis**. - Impaired hepatic function leads to decreased **estrogen metabolism** (hyperestrogenemia), contributing to the development of these vascular lesions. - They are one of the stigmata of chronic liver disease, along with palmar erythema and gynecomastia.

Practice by Chapter

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