Correct Answer - B
Ans. is B' i.e., Herpes genitalis
Herpes genitalis is a sexually transmitted disease, characterized by appearance of multiple painful vesicles in clusteres in genital area
which later on may ulcerate. These small ulcers may combine to
form a large ulcer. First attack of this in infection may be associated
with flu like symptoms but GIT symptoms are usually absent.
Gonorrhea is characterized by acute anterior arthritis associated
with thick yellow urethral discharge. Perianal ulceration is not a
feature of gonorrhea.
Although HIV can be considered in the differential diagnosis of
Perianal ulcers, but is usually associated with GIT symptoms.
Perianal ulceration is not a feature of CMV infection
@dermatology_vid
Correct Answer - A
Ans. is 'a' i.e., Atopic dermatitis
Hanifin and Rajka criteria is for diagnosis of atopic dermatitis.
Diagnostic criteria (Hanifin and Rajka)
Based mainly on clinical experience
Major criteria
1. Family history of atopy
2. Chronicity
3. Pruritus
4. Typical morphology and distribution
Minor criteria
1. Dry skin
2. Chelitis
3. Elevated edge
4. Dennie's line/dennie morgan fold (infra orbital fold)
5. White dermographism
6. Peripheral eosinophillia
7. Immediate (type i) hypersensivity
8. Facial pallor, orbital darkening
9. Food intolerance
10. Conjunctivitis (recurrent), keratoconus, cataract
11. Pityriasis albaHand dermatitis
13. Recurrent infections
At least 3 major or 2 major plus 2 minor criteria are necessary for
diagnosis
@dermatology_vid
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
1. Obesity (most common)
2. Endocrinopathies —> Hypothyroidism, hyperthyroidism, insuline
resistance diabetes, Cushing's disease, PCOD, Bloom syndrome.
3. Internal malignancy —> Gastric adenocarcinoma
@dermatology_vid
Correct Answer - C
Ans.C.Spinosum and basale
The Malpighian layer of the skin is generally defined as both the
stratum basale and stratum spinosum as a unit, although it is
occasionally defined as the stratum basale specifically,or the stratum
spinosum specifically. It is named after Marcello Malpighi.
@dermatology_vid
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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Correct Answer - C
Ans. C. Histologically there is hypermelanosis
Acanthosis nigricans is brown to black discolouration which usually
affects body folds like axilla, groin, umblicus, forehead.
Acanthosis nigricans occurs in individuals younger than 40 years of age.
It is associated with obesity (most common); endocrinopathy like
insulin resistance DM, hypothyroidism, Bloom synd., PCOD, and internal malignancy e.g. gastric adenocarcinoma.
Histopathologically, Papillomatosis is the characteristic feature
whereas there is no hypermelanosis.
@dermatology_vid
Correct Answer - A
Ans. is 'a' i.e., Keratin
Dermatophytes are keratinophillic fungi, living only on the superficial
dead keratin. That is why they infect skin, hair and nail. In skin they
infect most superficial layer of the epidermis i.e. stratum corneum.
They do not penetrate living tissues. Dermatophytes cause a variety
of clinical conditions, collectively known as dermatophytosis, tinea or
ringworm. Dermatophytes have been classified into 3 genera :-
trichophyton, microsporum, epidermophyton.
1. Trichophyton affects;- skin, hair, nails
2. Microsporum affects ;- skin, hair (nails are not affected)
3. Epidermophyton affects:- skin, nails (hair are not affected)
Deep fungal infections (eg:- maycetoma, chromoblastomycosis,
pheohyphomycosis, sporotrichosis, lobomycosis, rhinosporidiosis)
involve subcutaneous tissue.
Dermatophytosis is itchy and scaly
@dermatology_vid
Correct Answer - A
Answer- a. Lamellar ichthyosis
Explanation- Ichthyosis is one of the most commongenodermatoses. It is characterized by dry (xerotic) scaly skin all over the body. Scales are dull-brown-black.
The basic defect is an impairment in the barrier function of skin and
inability to maintain moisture. Collodion baby is the term used to
denote the newborn baby with ichthyosis; the newborn baby is
encased in a thick, shiny membrane coat called collodion and is
seen in Lamellar ichthyosis
Ref- Arvind Arora skin, 6th edition, page no 203
@dermatology_vid
Correct Answer - C
Ans. is 'c' i.e., Stratum corneum
Stratum basale, stratum spinosum and stratum granulosum,
together form the living layer and constitute the site of synthesis of
keratin
(Keratin is mostly synthesized in stratum spinosum).
Stratum corneum is the dead layer.
Layers of epidermis (From deep to superficial)
In palm and sole( 5layers)
Stratum basale
Stratum spinosum
Stratum granulosum
Stratum lucidum
Stratum corneum
Elsewhere (4layer)
Stratum basale
Stratum spinosum
Stratum granulosum
Stratum corneum
@dermatology_vid
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
