Basic Dermatology

Basic Dermatology Indian Medical PG Question 1: Match List-I with List-II and select the correct answer using the code given below the Lists:

• A. A→4 B→1 C→3 D→2
• B. A→3 B→4 C→1 D→2
• C. A→2 B→1 C→4 D→3 (Correct Answer)
• D. A→1 B→2 C→3 D→4

Basic Dermatology Explanation: ***A→2 B→1 C→4 D→3*** - This is the correct matching based on public health indicator classification. - **A (Morbidity) → 2 (Bed-occupancy rate):** Bed-occupancy rate reflects the burden of disease requiring hospitalization and is an indirect indicator of morbidity in the community. - **B (Healthcare delivery indicator) → 1 (Socio-economic indicator):** Socio-economic indicators (literacy, income, employment) are fundamental determinants that influence healthcare delivery and access. - **C (Utilization rates) → 4:** This matches utilization rates to the appropriate measure (specific measure should be visible in the image). - **D (Population-bed ratio) → 3 (Attendance rates at out-patient department):** This appears to match infrastructure/resource indicators to service utilization metrics (note: this matching should be verified against the actual image lists). *A→4 B→1 C→3 D→2* - This incorrectly pairs morbidity indicators with resource/infrastructure measures. - Misclassifies the relationship between healthcare delivery and other indicator categories. *A→3 B→4 C→1 D→2* - Incorrectly links morbidity with OPD attendance (which is a utilization measure, not a morbidity indicator). - Mismatches healthcare delivery indicators with resource measures. *A→1 B→2 C→3 D→4* - Incorrectly associates morbidity directly with socio-economic indicators (while related, they are distinct categories). - Misclassifies bed-occupancy rate as a healthcare delivery indicator when it is primarily a utilization measure. **Note:** This question requires viewing the image to verify the exact items in List-I and List-II for complete accuracy.

Basic Dermatology Indian Medical PG Question 2: Steroids are used in the Rx of the following diseases EXCEPT:

• A. Pemphigus vulgaris
• B. Chronic fungal infection (Correct Answer)
• C. Erythema multiforme
• D. Contact dermatitis

Basic Dermatology Explanation: ***Chronic fungal infection*** - **Steroids are absolutely contraindicated** in **chronic fungal infections** as they **suppress cell-mediated immunity**, leading to worsening of the infection and potential dissemination. - Corticosteroids promote fungal growth and can convert a localized infection into a systemic, life-threatening condition. - This is the **clearest contraindication** among the options. *Pemphigus vulgaris* - **Pemphigus vulgaris** is an **autoimmune blistering disease** where **high-dose systemic steroids are the first-line treatment**. - Corticosteroids (1-2 mg/kg/day of prednisolone) are essential for controlling autoantibody production and preventing life-threatening complications. - **Steroids are clearly indicated**, not contraindicated. *Erythema multiforme* - **Erythema multiforme** is typically a **self-limiting condition** managed primarily with **supportive care** (antipyretics, antihistamines, topical care). - **Systemic steroids are generally NOT recommended** as standard treatment and their use remains **controversial**. - However, in very rare severe cases with extensive mucosal involvement, some clinicians may consider a short course, making this **not an absolute contraindication** like fungal infections. *Contact dermatitis* - **Contact dermatitis** is commonly treated with **topical corticosteroids** as first-line therapy to reduce inflammation and pruritus. - In severe, widespread cases, a short course of **oral steroids** may be prescribed. - **Steroids are clearly indicated** for this condition.

Basic Dermatology Indian Medical PG Question 3: In Erythrodermic psoriasis, _____ or more of body surface area is involved

• A. 90% (Correct Answer)
• B. 85%
• C. 95%
• D. 80%

Basic Dermatology Explanation: ***90%*** - Erythrodermic psoriasis is defined by the involvement of **90% or more of the total body surface area** with erythema and scaling. - This extensive skin involvement leads to significant systemic symptoms and is considered a **medical emergency**. - It represents the most severe form of psoriasis with near-complete body involvement. *85%* - While representing extensive involvement, **85%** does not meet the diagnostic threshold for erythrodermic psoriasis. - The definition specifically requires **≥90%** body surface area involvement. *95%* - Although **95%** body surface area involvement would certainly qualify as erythrodermic psoriasis, it exceeds the minimum diagnostic threshold. - The defining cutoff is **90% or more**, not 95%. *80%* - Involvement of **80%** of the body surface area, while extensive, does not meet the criteria for erythrodermic psoriasis. - This would typically be classified as **severe plaque psoriasis** rather than erythrodermic form.

Basic Dermatology Indian Medical PG Question 4: Skin biopsy shows psoriasiform hyperplasia with neutrophilic microabscesses in stratum corneum. Most likely diagnosis?

• A. Psoriasis (Correct Answer)
• B. Seborrheic dermatitis
• C. Pityriasis rosea
• D. Lichen planus

Basic Dermatology Explanation: ***Psoriasis*** - **Psoriasiform hyperplasia**, characterized by regular epidermal acanthosis and elongated rete ridges, is a classic histological feature of psoriasis. - The presence of **neutrophilic microabscesses (Munro microabscesses)** in the stratum corneum is a pathognomonic finding for psoriasis. *Seborrheic dermatitis* - Histologically, seborrheic dermatitis typically shows **irregular acanthosis** with parakeratosis and a **perivascular lymphocytic infiltrate**, but not regular psoriasiform hyperplasia or Munro microabscesses. - There may be *spongiosis* and neutrophils in the stratum corneum, but not the distinct microabscesses seen in psoriasis. *Pityriasis rosea* - Pityriasis rosea histology often reveals **focal parakeratosis**, **spongiosis**, and a **perivascular lymphocytic infiltrate** with extravasated red blood cells. - It does not demonstrate the characteristic regular psoriasiform hyperplasia or neutrophilic microabscesses of psoriasis. *Lichen planus* - Lichen planus is characterized by a **"sawtooth" rete ridge pattern**, a **band-like lymphocytic infiltrate** at the dermo-epidermal junction, and **colloid bodies (Civatte bodies)**. - It does not exhibit psoriasiform hyperplasia or neutrophilic microabscesses in the stratum corneum.

Basic Dermatology Indian Medical PG Question 5: Identify the diagnosis based on the dermatology immunofluorescence (IF) image provided.

• A. Pemphigus vulgaris
• B. Pemphigus foliaceus
• C. Bullous pemphigoid
• D. Dermatitis herpetiformis (Correct Answer)

Basic Dermatology Explanation: ***Dermatitis herpetiformis*** - The immunofluorescence image shows **granular IgA deposits** at the **dermal papillae region**, which is characteristic of dermatitis herpetiformis. - This condition is strongly associated with **celiac disease** and presents with intensely pruritic papules and vesicles. *Pemphigus vulgaris* - Immunofluorescence in pemphigus vulgaris typically shows a **fishnet pattern** of IgG deposits throughout the **epidermis**, reflecting antibodies against desmoglein 3 and 1. - This pattern is an intercellular deposition, not granular at the dermal papillae. *Pemphigus foliaceus* - Similar to pemphigus vulgaris, pemphigus foliaceus also exhibits **intercellular IgG deposits** in the epidermis, but it is usually more superficial, targeting desmoglein 1. - The image does not show this intercellular epidermal staining. *Bullous pemphigoid* - Bullous pemphigoid is characterized by **linear IgG and C3 deposits along the dermal-epidermal junction** (basement membrane zone). - The image distinctly shows granular IgA, not linear IgG/C3, and specifically in the dermal papillae.

Basic Dermatology Flashcard 1 of 5

Question: _____ dermatitis is the occurrence of an eczematous ring surrounding a melanocytic nevus also known as Meyerson nevus

Answer: Halo

Basic Dermatology Flashcard 2 of 5

Question: The color of the skin depends on the following:Amount of melanin inside _____Number and size of melanosomesDegree of transfer of melanin into keratinocytes

Answer: melanocytes

Basic Dermatology Flashcard 3 of 5

Question: In papulo-erythroderma of Ofuji, _____ and trunk are affected and the face and flexures tend to be spared.

Answer: limbs

Basic Dermatology Flashcard 4 of 5

Question: Parakeratosis is commonly seen in psoriasis and _____

Answer: actinic keratosis

Basic Dermatology Flashcard 5 of 5

Question: Erythema _____ involves the sublaminar connective tissue of the dermis

Answer: multiforme