INI-CET 2017 - Dermatology PYQs Practice Questions

Q: What is the diagnosis based on the image shown below?

Mycosis fungoides. ***Mycosis fungoides*** - The image exhibits **Pautrier microabscesses**, which are collections of atypical lymphocytes within the epidermis, a hallmark of mycosis fungoides. - There is also a **band-like infiltrate of atypical lymphocytes** in the upper dermis, characteristic of this cutaneous T-cell lymphoma. *Pemphigus* - Pemphigus is characterized by **intraepidermal blistering due to acantholysis** (loss of cohesion between keratinocytes), which is not seen in this image. - Histology would show separated keratinocytes, often with a "tombstone" appearance of basal cells, and **no Pautrier microabscesses**. *Dermal leishmaniasis* - Dermal leishmaniasis is caused by _Leishmania_ parasites and typically presents with a **dermal infiltrate rich in macrophages** containing intracellular amastigotes. - The image does not show these features; instead, it shows an atypical lymphoid infiltrate. *Psoriasis* - Psoriasis typically shows **acanthosis (epidermal hyperplasia)** with elongation of rete ridges, **parakeratosis**, and **Munro microabscesses** (neutrophilic collections in the stratum corneum). - While there is some epidermal thickening, the distinct Pautrier microabscesses and atypical lymphoid infiltrate are not features of psoriasis. [Practice more Dermatology PYQs on OnCourse]

Q: A child has a pruritic rash as shown below. His mother is an asthmatic. Comment on the diagnosis:

Atopic dermatitis. ***Atopic dermatitis*** - The image shows a classic presentation of **eczematous rash** in the **flexural areas** (knees), which is characteristic of atopic dermatitis. - The history of a **mother with asthma** suggests an **atopic diathesis**, increasing the likelihood of atopic dermatitis in the child due to its strong genetic component and association with other atopic conditions (asthma, allergic rhinitis). *Seborrheic dermatitis* - Typically presents as **greasy, yellowish scales** on an erythematous base, commonly affecting the scalp, face (eyebrows, nasolabial folds), and chest. - While it can occur in infants ("cradle cap"), its morphology and locations are distinct from the rash seen in the image. *Allergic contact dermatitis* - This rash would typically be localized to areas of direct contact with an **allergen** and would not necessarily show the typical flexural distribution seen in the image. - It often presents with more acute **vesicles, bullae, and intense pruritus** strictly limited to the exposure site. *Erysipelas* - Erysipelas is a **superficial bacterial skin infection** characterized by a **well-demarcated, erythematous, raised, and warm plaque**, often with systemic symptoms like fever and chills. - The rash in the image does not present with the characteristic features of an acute bacterial infection. [Practice more Dermatology PYQs on OnCourse]

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. [Practice more Dermatology PYQs on OnCourse]

Question 1

A 25-year-old lady presents with painful blisters in oral mucosa and skin. Direct immune-fluorescence picture is given below. Which of the following is incorrect about the condition shown?

Accepted Answer

Basement membrane deposition of IgG is the most common DIF picture in bullous lesions

Answer

Antibodies against hemidesmosomes

Answer

Antibodies against desmoglein 1

Answer

Antibodies against desmoglein-3

Question 2

What is the diagnosis based on the image shown below?

Accepted Answer

Mycosis fungoides

Answer

Pemphigus

Answer

Dermal leishmaniasis

Answer

Psoriasis

Question 3

A 30-year-old male presents with joint pain and NSAIDs were prescribed. After one week, joint pain is persisting and he has developed brownish discoloration over nose as shown in the figure. This was due to: (AIIMS Nov 2017)

Accepted Answer

Fixed drug eruption

Answer

Melasma

Answer

Chikungunya

Answer

Dengue

Question 4

A child has a pruritic rash as shown below. His mother is an asthmatic. Comment on the diagnosis:

Accepted Answer

Atopic dermatitis

Answer

Seborrheic dermatitis

Answer

Allergic contact dermatitis

Answer

Erysipelas

Question 5

The skin condition shown in the image is associated with?

Accepted Answer

Diabetes mellitus

Answer

Hypothyroidism

Answer

Hyperthyroidism

Answer

Sarcoidosis

Question 6

A middle-aged man came to you with itchy rash caused by the following organism. Identify the condition: (AIIMS Nov 2017)

Accepted Answer

Scabies

Answer

Insect bite reaction

Answer

Pediculosis

Answer

Tinea cruris

Question 7

Identify the condition which is present since birth: (AIIMS May 2017)

Accepted Answer

Congenital nevus

Answer

Epidermal verrucous nevus

Answer

Melano-acanthoma

Answer

Malignant melanoma

Question 8

A child has been brought with the following scalp lesion with history of itching in scalp and hair loss for past 2 months. Which of the following is useful for diagnosis of this patient? (AIIMS May 2017)

Accepted Answer

KOH mount

Answer

Gram stain

Answer

Slit skin smear

Answer

Tzanck smear

Question 9

The following patient presented to the OPD with history of hair loss. There was no erythema, scarring or scratching. Diagnosis is:

Accepted Answer

Alopecia areata

Answer

Trichotillomania

Answer

Telogen effluvium

Answer

Tinea infection

Question 10

The image given below shows:

Accepted Answer

Cutaneous horn

Answer

Papilloma

Answer

Cock's peculiar tumor

Answer

Glomus tumor

INI-CET 2017 — Dermatology