Pg Blazer - Online Test Series 32 - Dermatology

1. A 24-year old unmarried woman has multiple nodular, cystic, pustular and comedonal lesions on face, upper back and shoulders for 2 years. The drug of choice for her treatment would be:

Acitretin

Isotretinoin

Doxycycline

Azithromycin

The clinical picture is diagnostic of acne vulgaris. Isotretinoin is used in severe intractable acne.

Explanation

The clinical picture is diagnostic of acne vulgaris. Isotretinoin is used in severe intractable acne.

2. Air borne contact dermatitis can be diagnosed by:

Skin biopsy

Patch test

Prick test

Estimation of serum IgE levels

In patch test, the suspected allergens are applied on the back of the patient under separate patches for 48 hours. The presence of dermatitis is then looked for.

Explanation

In patch test, the suspected allergens are applied on the back of the patient under separate patches for 48 hours. The presence of dermatitis is then looked for.

3. Pterygium of nail is characteristically seen in:

Lichen planus

Psoriasis

Tinea unguium

Alopecia areata

Pterygium of the nail refers to a triangular or wing-like growth of the nail plate over the proximal nail fold. This is a characteristic finding in lichen planus, an inflammatory skin condition that can affect the nails. Lichen planus can cause various nail abnormalities, including pterygium formation. Psoriasis, tinea unguium (fungal infection of the nails), and alopecia areata are not typically associated with pterygium of the nail.

Explanation

Pterygium of the nail refers to a triangular or wing-like growth of the nail plate over the proximal nail fold. This is a characteristic finding in lichen planus, an inflammatory skin condition that can affect the nails. Lichen planus can cause various nail abnormalities, including pterygium formation. Psoriasis, tinea unguium (fungal infection of the nails), and alopecia areata are not typically associated with pterygium of the nail.

4. A patient had seven irregular hyperpigmented macules on the trunk and multiple small hyperpigmented macules in the axillae and groins since early childhood. There were no other skin lesions. Which is the most likely investigation to support the diagnosis?

Slit lamp examination of eye

Measurement of intraocular tension

Examination of fundus

Retinal artery angiography

The irregular hyperpigmented macules since early childhood are probably cafe au lait macules. Presence of 6 or more cafe au lait macules is diagnostic of neurofibromatosis type I even when cutaneous neurofibromas are absent. Lisch nodules on the iris can be demonstrated by slit lamp examination and it helps support the diagnosis.

Explanation

The irregular hyperpigmented macules since early childhood are probably cafe au lait macules. Presence of 6 or more cafe au lait macules is diagnostic of neurofibromatosis type I even when cutaneous neurofibromas are absent. Lisch nodules on the iris can be demonstrated by slit lamp examination and it helps support the diagnosis.

5. An 8 year old boy from Bihar presents with a 6 months history of an ill defined, hypopigmented slightly atrophic macule on the face. The most likely diagnosis is:

Pityriasis alba

Indeterminate leprosy

Morphea

Calcium deficiency

Bihar is a known endemic region for leprosy.

Explanation

Bihar is a known endemic region for leprosy.

6. A 16 year-old boy presented with asymptomatic, multiple, erythematous, annular lesions with a collarette of scales at the periphery of the lesions present on the trunk. The most likely diagnosis is:

Pityriasis versicolor

Pityriasis alba

Pityriasis rosea

Pityriasis rubra pilaris

The classical lesions of pityriasis rosea are described in the question.

Explanation

The classical lesions of pityriasis rosea are described in the question.

7. All of the following drugs are effective in the treatment of pityriasis versicolor except:

Selenium sulphide

Ketoconazole

Griseofulvin

Clotrimazole

Griseofulvin is used in the treatment of dermatophyte infections.

Explanation

Griseofulvin is used in the treatment of dermatophyte infections.

8. A 6 month old infant had itchy erythematous papules and exudative lesions on the scalp, face, groins and axillae for one month. She also had vesicular lesions on the palms. The most likely diagnosis is:

Congenital shypilis

Seborrheic dermatitis

Scabies

Psoriasis

Based on the symptoms described, the most likely diagnosis is scabies. Scabies is a contagious skin condition caused by the Sarcoptes scabiei mite. It is characterized by intense itching, erythematous papules, and exudative lesions, particularly in areas such as the scalp, face, groins, and axillae. The presence of vesicular lesions on the palms is also consistent with scabies. Congenital syphilis would typically present with different symptoms, such as rash on the palms and soles, hepatosplenomegaly, and other systemic manifestations. Seborrheic dermatitis and psoriasis may cause similar symptoms, but the distribution and vesicular lesions make scabies a more likely diagnosis.

Explanation

Based on the symptoms described, the most likely diagnosis is scabies. Scabies is a contagious skin condition caused by the Sarcoptes scabiei mite. It is characterized by intense itching, erythematous papules, and exudative lesions, particularly in areas such as the scalp, face, groins, and axillae. The presence of vesicular lesions on the palms is also consistent with scabies. Congenital syphilis would typically present with different symptoms, such as rash on the palms and soles, hepatosplenomegaly, and other systemic manifestations. Seborrheic dermatitis and psoriasis may cause similar symptoms, but the distribution and vesicular lesions make scabies a more likely diagnosis.

9. In which of the following conditions Parakeratosis most frequently occurs?

Actinic keratoses

Seborrheic keratoses

Molluscum contagiosum

Basal cell carcinoma

Parakeratosis refers to the persistance of cellular nuclei in the stratum corneum of skin.

Explanation

Parakeratosis refers to the persistance of cellular nuclei in the stratum corneum of skin.

10. A 45 year old farmer has itchy erythematous papular lesions on face, neck, 'V' area of chest, dorsum of hands and forearms for 3 years. The lesions are more severe in summer and improve by 75% in winter. The most appropriate test to diagnose the condition would be:

Skin biopsy

Estimation of IgE levels in blood

Patch test

Intradermal prick test

The history is suggestive of photodermatitis. Patch test is used for diagnosis of photodermatitis.

Patch test (photopatch test) : Here, 2 patches containing photosensitising material is applied on 2 different sites on the body. One of them is irradiated with UVA rays. The other is kept as control. Development of eczema is looked for upto 72 hours.

Analysis of results:

No development of eczema – patient does not have photodermatitis
Development of eczema under the patch irradiated with UVA – Photodermatitis
Development of eczema under both patches – Contact dermatitis

Explanation

The history is suggestive of photodermatitis. Patch test is used for diagnosis of photodermatitis.

Patch test (photopatch test) : Here, 2 patches containing photosensitising material is applied on 2 different sites on the body. One of them is irradiated with UVA rays. The other is kept as control. Development of eczema is looked for upto 72 hours.

Analysis of results:

No development of eczema – patient does not have photodermatitis
Development of eczema under the patch irradiated with UVA – Photodermatitis
Development of eczema under both patches – Contact dermatitis