Correct Answer - C
Ans. C. Topical gentamycin
[Ref IADVL 3rd/e p. 235]
* "Topical use of gentamycin should be avoided as gentamycin
resistance can develop and it can be transferred between different
species and strains of staphylococcus."
Treatment of impetigo
* Impetigo contagiosum
- Localized 4 Topical antibiotics like fusidic acid or mupirocin
- Extensive - Systemic antibiotics (erythromycin group to cover
staphylococcus and streptococcus).
- If response is poor, oxacillin-Clavulanic acid or cephalexin can be
tried.
Bullous Impetigo
* Localized→ Topical fusidic acid or mupirocin
* Extensive 4 Systemic antistaphylococcal antibiotics (flucloxacillin,
amoxicillin- clavulanic acid, methicillin or erythromycin)
@dermatology_vid
Correct Answer - B
Ans. B. Loss of all body hair
[Ref Fitzpatrick]
In alopecia aerata, when there is total loss of scalp hair it is called
Alopecia totalis.
When there is loss of total body hair it is referred as Alopecia
universalis.
Alopecia along the scalp margin is called ophiasis.
An inverse ophiasis pattern (sisaphio) is when it spares occipital region and affects rest of the scalp.
@dermatology_vid
Correct Answer - C
Ans. is 'c' i.e., Testosterone
Predisposing factors for Acne vulgaris
Genetic factors
Hormones -4 Androgens, glucocorticoids.
Psychological stress and depression.
Environmental factors High temperature & humidity.
Cosmetics -3 Containing lenolin, petroleum, vegetable oils.
Infection --> Propionibacterium, Pityrosporum, Staph. epidermidis.
Menstural cycle -4 Premenstural aggravation.
Hyperkeratosis of pilosebaceous ostia.
Drugs Antepileptics (Carbamazepine, phenytoin, phenobarbitone),
antitubercular (INH, rifampin, ethionamide), antidepressants,
cyclosporine, Vitamin B12
.Cough syrups containing halogens
(Iodides, bromides).
@dermatology_vid
Correct Answer - C
Ans. is 'c' i.e., Hyperthyroidism
Hair loss in combination with velvety skin is seen in patients with
excess of thyroid hormone production; thus the most probable
answer is hyperthyroidism
@dermatology_vid
Correct Answer - A
Sutton's nevus/halo's nevus : a halo of depigmentation appears around a preexisting melanocytic naevus.
Meyerson’s naevus is used to describe a melanocytic naevus that has developed
an associated inflammatory
reaction, which looks like eczema.
Ref: Rook's textbook of dermatology, 8th edition Pg 54.20.
Correct Answer - A
Ans:A. Leukoderma
Leukoderma is a skin disease that causes loss of skin pigmentation
(melanin) that leads to skin whitening.
The white patches on the skin are termed as leukoderma.
When the condition gets severe, the spots cover almost all parts of
the body including scalp, face and the genitals.
Correct Answer - D
Ans. is 'd' i.e., All of the above
Acanthosis nigricans
Acanthosis nigricans is a brown to black, velvety hyperpigmentation of the skin. It is usually found in body folds, such as posterior & lateral folds of neck, axilla, groin, umblicus, forehead. It typically occurs in individuals younger than 40 years of age.
Histopathologically papillomatosis is characteristically seen; however, there is no hypermelanosis and there is only mild acanthosis, if present.
It is associated with
Obesity (most common)
Endocrinopathies-> Hypothyroidism, hyperthyroidism, insuline resistance diabetes, Cushing's disease, PCOD, Bloom syndrome. 3. Internal malignancy-> Gastric adenocarcinoma
Correct Answer - A
Ans. is 'a' i.e., Cornybacterium
Erythrasma is a skin disease that causes brown, scaly skin patches.
It is caused by the Gram-positivebacterium
Corynebacteriumminutissimum. It is prevalent among diabetics and
the obese, and in warm climates; it is worsened by wearing
occlusive clothing.
85) Explanation
• Hallmark features of SECONDARY SYPHILIS:
asymptomatic, bilateral symmetrical pleomorphic
maculo-papular rash on palms and soles, non-tender
lymphadenopathy.
• Other findings: Condyloma Lata, Moth Eaten Alopecia
arthritis, proteinuria.
• Features that are never seen: Vesico-bullous lesions,
intense pruritus, Interstitial Keratitis.
84) Explanation
Acanthosis: Thickening of stratum spinosum aka prickle cell layer.
83) A 43-year-old woman develops a rash on her arms and hands after starting a new job in a factory. The lesions have well-demarcated erythema and edema with superimposed closely spaced vesicles and papules. Findings might include
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81) A 19-year-old man develops new lesions at the sites of skin trauma. The lesions appear as
sharply marginated erythematous papules
with silvery-white scales
80) A 32-year-old man with human immunodeficiency virus (HIV) infection develops skin tumors and patches on the legs with some on the face. They are palpable, firm, and appear
violaceous with some nodules appearing
purple brownish.
79) A 19-year-old woman with asthma has a chronic rash with distribution on her hands, neck, and elbow creases. It is very itchy, and the skin appears thickened with increased skin markings. There are some areas of fissures in the skin at the elbow creases and hands. Which of the following is the most appropriate advice? (See Fig. )
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Correct Answer - B
Ans. B. Leishmaniasis
Volcano sign:
Descriptive term for the morphologic feature of Old World cutaneous
leishmaniasis.
Lesion starts as small non tender papule which enlarge in size and ulcerated in center.
-The border of crusted ulcer often has erythmatous rim called as 'volcano sign.'
@dermatology_vid
Correct Answer - C
Ans. C. Plaque
Petechiae are small pin point purpuric macular lesions that occur
due to extravasation of red blood cells from cutaneous vessels into
the skin.
Echryosis are larger bruise like hemorrhagic lesions. Cause is
generally non inflammatory.
Plaque is a solid plateau like elevation that occupies a large surface
area in comparison to its height above the normal skin and has a
diameter more than 0.5 cms. There is no hemorrhage involved as
such
@dermatology_vid
Correct Answer - A
Ans. is 'a' i.e., Stratum corneum
After copulation, the male mite dies and the female mite burrows into
the superficial skin layer (stratum cornuem) at the rate of 2 mm/day.
Female mite lays eggs which hatch into larva, which moulds and
mature into adult mites.
The mite then burrows into stratum corneum.
These burrow is visible clinically as an irregular gray-brown line.
Burrow is a pathognomic sign for scabies.
@dermatology_vid
Correct Answer - D
Ans. is 'd' i.e., Crohns disease
Vitiligo is associated with the following autoimmune diseases :-
Alopecia areata
Diabetes mellitus
Hyperthyroidism
Hypothyroidism
Pernicious anemia
Addison disease
Multiple endocrinopathy syndrome
@dermatology_vid
Correct Answer - D
Ans. is 'd' i.e., Psoriasis
Bedside tests for psoriasis
Two bedside tests can be done to confirm the clinical diagnosis of
psoriasis : -
i. Grattage test
Scraping the lesion with a glass slide causes accentuation of the
silvery scales.
ii. Auspitz's Sign
Scraping the lesion with glass slide causes accentuation os slivery
scales (as in Grattage test). If scraping is continued further, a
glistening white adherent membrane (Burlkey's membrane) appears.
On removing Burlkey's membrane punctate (fine pin point) bleeding
become visible, which is referred to as Auspitz's sign.
Correct Answer - B
Ans. is 'b' i.e., Becker nevus
Becker Nevus
Usually starts in adolescence as an irregular smooth
hyperpigmented macule.
Usually involves shoulder, anterior chest and scapular region,
although any part of the may be involved.
Slowly grows in size of a palm wile acquiring thick dark hair.
Often lesion resembling acne vulgaris in different stages may appear
on surface.
No treatment is required.
Correct Answer - A
Ans. is 'a' i.e., Ketoconazole
Pityriasis versicolor (Tinea versicolor)
Tinea versicolor is a misnomer as it is not caused by dermatophyte;
Pityriasis versicolor is more appropriate term. It is caused by a
nondermatophyte fungus called Pityrosporum ovale (Malasezia
furfur). It usually affects young adults.
Clinical features
There are multiple small scaly hypopigmented macules (macules
may be hyperpigmented also). Scaling is furfuraceous or rice
powder like. Macules start around the hair follicles and then merge
with each other to form large areas. Affects trunk and shoulders
(mainly chest and back). There may be loosening of scales with
finger nails -4 Coupled onle or stroke of nail. Lesions are recurrent in
nature (may reappear after treatment).
Diagnosis of P.versicolor
Examination of scales in 10% KOH shows short hyphae and round
spores (Sphagetti and meat ball appearance). Wood's lamp shows
apple green fluorescence (blue-green fluorescence). Skin surface
biopsy —) A cyanoacrylate adhesive (crazy glue) is used to remove
the layer of stratum corneum on glass slide and then stained with
PAS reagent... Treatment of P.versicolor
1. Systemic agents : - Systemic azoles provide a convenient
therapeutic option. Drugs used are ketoconazole, Fluconazole or
intraconazole.
2. Topical antifungals :- Topical antifungals used are : -
i. Azoles —> Clotrimazole, econazole, Miconazole, Ketoconazole.
ii. Others —> Selenium Sulfide, Sodium thiosulphate, whield's
ointment (3% salicylic acid + 6% Benzoic acid).
Correct Answer - D
Ans. D. i.e. Tzanck smear from the floor of bulla
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83) Explanation
The history should not reveal worsening eruption during the weekend. Allergy, acne, diabetes, psoriasis, xeroderma, or seborrheic dermatitis may all be mistaken for occupational disorders. The list of possible occupational skin hazards is long. At times, a site visit to the workplace is required to confirm the diagnosis. First aid in the workplace often involves sensitizing agents that worsen the situation. Skin problems can be severe and permanent. Relatively few patients are malingerers.
82) Explanation
Verrucae are viral in etiology. The human papillomavirus is a DNA-containing virus of the papovavirus group that includes animal tumor viruses. Although most warts are not felt to be premalignant; there is evidence to show that genital warts are correlated with malignancy
81) Explanation
Koebner phenomenon is typically seen in
psoriasis. The kind of injury eliciting the phe nomenon is usually mechanical, but ultraviolet light or allergic damage to the skin may be provocative. Koebner phenomenon can also occur in lichen planus, lichen nitidus, keratosis follicularis, and pemphigoid. The Koebner phenomenon has been used to study early skin changes in these diseases.
80) Explanation
Kaposi sarcoma often manifests as multiple
blue dermal plaques. Lesions have two prominent features: accumulation of spindle cells and presence of vascular elements. Classical Kaposi sarcoma is an indolent disease of later life and is much more common in men than women.
Kaposi sarcoma in association with HIV infection is a much more aggressive disorder. In all types of Kaposi the deoxyribonucleic acid (DNA) of human herpes virus 8 has been identified
79) Explanation
A change of environment is among the best treatments for atopic dermatitis. The patient should be kept in as dust-free an environment as possible and should not wear rough garments. Maintenance of adequate humidity is also important.
78) Explanation
This tumor as a rule occurs on exposed, hairy skin. It grows rapidly but involutes slowly, occasionally up to 1 year. It is more common in white-skinned males. The lesion starts as a small, rounded, flesh-colored or red dish papule. It grows rapidly and may reach 10–20 mm in a few weeks. There are telangiectasias just below the surface and the center contains a horny plug or is covered by a crust concealing a keratin-filled crater. Histology can be difficult to differentiate from squamous cell cancer.
