Dermatitis and Eczema Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Dermatitis and Eczema. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Dermatitis and Eczema Indian Medical PG Question 1: Which of the following are treatment options for acne vulgaris?
- A. Isotretinoin
- B. All of the options (Correct Answer)
- C. Topical erythromycin
- D. Oral Minocycline
Dermatitis and Eczema Explanation: ***All of the options***
- All listed options (Isotretinoin, Topical erythromycin, and Oral Minocycline) are well-established and commonly used **treatment options for acne vulgaris**, depending on the severity and type of acne.
- The choice of treatment often follows a stepped approach, starting with topical agents for mild to moderate acne and progressing to oral medications like antibiotics or isotretinoin for more severe or resistant cases.
*Isotretinoin*
- **Isotretinoin** is a powerful oral retinoid primarily used for **severe, recalcitrant nodular acne** that has not responded to other treatments.
- It works by reducing sebum production, follicular hyperkeratinization, inflammation, and the growth of *P. acnes*.
*Topical erythromycin*
- **Topical erythromycin** is an **antibiotic** used to treat mild to moderate inflammatory acne by reducing the growth of *Cutibacterium acnes* (formerly *Propionibacterium acnes*) and decreasing inflammation.
- It is often combined with other topical agents like benzoyl peroxide to minimize the development of **antibiotic resistance**.
*Oral Minocycline*
- **Oral minocycline** is a **tetracycline antibiotic** used for moderate to severe inflammatory acne.
- It reduces bacterial populations on the skin and exhibits **anti-inflammatory properties**, making it effective for widespread or deeper lesions.
Dermatitis and Eczema Indian Medical PG Question 2: A person has presented with history of dog-bite on the uncovered surface of his right leg. There is a minor abrasion without bleeding. Consider the following statements about management :
1. The bite should be taken as a category I contact with suspect animal
2. The bite requires local treatment of the wound
3. The person requires immediate vaccination
4. The person requires immediate administration of rabies immunoglobulin Which of the above statements are correct ?
- A. 2 and 3 only (Correct Answer)
- B. 1 and 2
- C. 2, 3 and 4
- D. 3 and 4 only
Dermatitis and Eczema Explanation: ***2 and 3 only***
- A minor abrasion without bleeding falls under **Category II exposure** per WHO guidelines, requiring **local wound treatment** and **immediate vaccination**.
- **Category II exposures** are defined as nibbling of uncovered skin, minor abrasions without bleeding, or scratches without bleeding.
*1 and 2*
- The bite described (minor abrasion without bleeding) is classified as **Category II exposure** by WHO, not Category I.
- **Category I contact** involves touching or feeding an animal, or licks on intact skin, requiring **no post-exposure prophylaxis** as there is no breach of skin integrity.
*2, 3 and 4*
- While local wound treatment and vaccination are correct for Category II exposure, **rabies immunoglobulin (RIG)** is not indicated for Category II.
- RIG is reserved for **Category III exposures**, which involve single or multiple transdermal bites or scratches, contamination of mucous membranes with saliva, or licks on broken skin.
*3 and 4 only*
- Immediate vaccination is correct, but **rabies immunoglobulin** is not necessary for a minor abrasion without bleeding (Category II exposure).
- Administration of RIG is only indicated after **Category III exposures** due to the higher risk of rabies transmission.
Dermatitis and Eczema Indian Medical PG Question 3: Match the following scale types with their lesions.
| Scales | Lesions |
| :-- | :-- |
| 1. Collarette scales | a. Pityriasis versicolour |
| 2. Silvery scales | b. Pityriasis rosea |
| 3. Mica-like scales | c. Psoriasis |
| 4. Branny scales | d. Pityriasis lichenoides |
- A. 1-d, 2-c, 3-a, 4-b
- B. 1-c, 2-b, 3-d, 4-a
- C. 1-a, 2-b, 3-d, 4-c
- D. 1-b, 2-c, 3-d, 4-a (Correct Answer)
Dermatitis and Eczema Explanation: ***1-b, 2-c, 3-d, 4-a***
- **Collarette scales** are pathognomonic of **Pityriasis rosea**, appearing as fine, trailing scales around the periphery of oval lesions in a "Christmas tree" distribution.
- **Silvery scales** are the classic hallmark of **Psoriasis**, presenting as thick, adherent, silvery-white scales overlying well-demarcated erythematous plaques.
- **Mica-like scales** are characteristic of **Pityriasis lichenoides**, appearing as thick, shiny, adherent scales that can be peeled off like mica sheets.
- **Branny scales** are typical of **Pityriasis versicolor**, presenting as fine, powdery scales caused by **Malassezia** yeast overgrowth.
*1-d, 2-c, 3-a, 4-b*
- Incorrectly matches **collarette scales with Pityriasis lichenoides**, which typically presents with mica-like scales, not collarette scales.
- Misassociates **mica-like scales with Pityriasis versicolor**, which characteristically has branny (fine, powdery) scales.
*1-c, 2-b, 3-d, 4-a*
- Wrongly pairs **collarette scales with Psoriasis**, which is known for thick silvery scales, not peripheral collarette scales.
- Incorrectly matches **silvery scales with Pityriasis rosea**, which has collarette scales at lesion periphery, not silvery scales.
*1-a, 2-b, 3-d, 4-c*
- Falsely associates **collarette scales with Pityriasis versicolor**, which has branny scales from yeast infection, not collarette scales.
- Mismatches **branny scales with Psoriasis**, which has characteristic thick silvery scales, not fine powdery scales.
Dermatitis and Eczema Indian Medical PG Question 4: 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)
Dermatitis and Eczema 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.
Dermatitis and Eczema Indian Medical PG Question 5: A 25-year-old patient presents with chronic itchy, erythematous skin lesions on the flexural areas that have been recurring since childhood. The patient has a family history of asthma. Which of the following is the most important diagnostic criterion for the most likely diagnosis?
- A. Personal or family history of atopy
- B. Elevated serum IgE levels
- C. Early age of onset (before 2 years)
- D. Chronic pruritic eczema with typical morphology and distribution (Correct Answer)
Dermatitis and Eczema Explanation: ***Chronic pruritic eczema with typical morphology and distribution***
- The patient presents with **chronic**, **itchy**, **erythematous lesions** on the **flexural areas** (e.g., antecubital and popliteal fossae), characteristic of **atopic dermatitis** (eczema).
- The **recurrence since childhood** and the typical distribution represent the **major diagnostic criteria** based on clinical morphology and distribution.
- **Clinical presentation with typical morphology** is the **primary diagnostic criterion** according to Hanifin and Rajka criteria.
*Elevated serum IgE levels*
- While **elevated serum IgE** is often associated with atopic dermatitis, it is a **minor criterion** and a **laboratory finding**, not a primary diagnostic feature.
- It reflects an **atopic predisposition**, but **clinical morphology and distribution** remain the most important diagnostic factors.
*Personal or family history of atopy*
- A **family history of asthma** (an atopic condition) is a **minor criterion** that supports the diagnosis of atopic dermatitis.
- However, this is a **predisposing/supporting factor**, not as important as the characteristic clinical morphology and distribution.
*Early age of onset (before 2 years)*
- While atopic dermatitis often begins in **infancy or early childhood**, this is a **minor criterion** in the diagnostic framework.
- The question states symptoms **recurring since childhood** but onset timing is less diagnostically important than the characteristic **clinical presentation** with typical morphology and distribution.
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