FMGE 2018 - Dermatology PYQs Practice Questions

Q: Most common subtype of Rodent ulcer is:

Nodular. ***Nodular*** - The **nodular** subtype is the most common presentation of **basal cell carcinoma (rodent ulcer)**, accounting for 60-80% of cases. - It typically appears as a **pearly nodule** with rolled borders and telangiectasias. *Superficial* - The **superficial** subtype is the second most common, accounting for 15-20% of basal cell carcinomas. - It presents as a **red, scaly patch**, often mistaken for eczema or psoriasis. *Pigmented* - The **pigmented** subtype is less common, characterized by the presence of **melanin**, making it appear dark brown or black. - It can be confused with melanoma due to its dark coloration. *Cystic* - The **cystic** subtype is a rare form of basal cell carcinoma, characterized by a **fluid-filled lesion**. - It often appears as a translucent nodule with a soft, jelly-like consistency. [Practice more Dermatology PYQs on OnCourse]

Q: What are these horizontal lines seen on the skin called?

Blaschko lines. ***Blaschko lines*** - **Blaschko lines** are invisible lines of normal skin development, thought to represent migration paths of **epidermal cells** during embryogenesis. - They become visible in certain skin conditions, such as **pigmentary disorders (e.g., incontinentia pigmenti)** and **linear epidermal nevi**, manifesting as distinctive linear or whorled patterns. *Dermatomes* - **Dermatomes** represent areas of skin innervated by a single **spinal nerve root**. - Conditions like **herpes zoster (shingles)** follow a dermatomal pattern. *Vascular development* - **Vascular development** refers to the formation of blood vessels, which are crucial for oxygen and nutrient delivery. - Anomalies in vascular development lead to conditions like **hemangiomas** or **vascular malformations**. *Lymphatic development* - **Lymphatic development** involves the formation of the lymphatic system, important for fluid balance and immune function. - Abnormalities can result in **lymphedema** or **lymphatic malformations**. [Practice more Dermatology PYQs on OnCourse]

Q: All of the following are manifestations of congenital syphilis except:-

Gumma. ***Gumma*** - **Gumma** is a manifestation of **tertiary syphilis** in adults, typically appearing years after the initial infection [1]. - While syphilis can be transmitted congenitally, **gummatous lesions** are not a characteristic finding in congenital syphilis [1]. *Olympian brow* - **Olympian brow** (also known as frontal bossing) is a feature of **congenital syphilis**, characterized by prominent frontal bones [2]. - It results from **periostitis** and abnormal bone development due to chronic infection in utero. *Interstitial keratitis* - **Interstitial keratitis** is a classic manifestation of **late congenital syphilis**, affecting the cornea [2]. - It presents as **bilateral corneal inflammation** leading to vision impairment, often appearing in childhood or adolescence. *Hutchinson's teeth* - **Hutchinson's teeth** are a pathognomonic sign of **congenital syphilis**, characterized by notched, peg-shaped, and widely spaced incisors. - This dental abnormality results from the treponemal infection disrupting the **enamel formation** during tooth development. [Practice more Dermatology PYQs on OnCourse]

Q: A child presents with the skin lesions shown in the image. The most likely diagnosis is:

Impetigo contagiosa. ***Impetigo contagiosa*** - The image shows **honey-colored crusted lesions** around the mouth, which are highly characteristic of **impetigo contagiosa (non-bullous impetigo)**. - This form of impetigo is typically caused by *Staphylococcus aureus* or *Streptococcus pyogenes* and primarily affects superficial layers of the epidermis. *Bullous impetigo* - Characterized by **flaccid bullae** (blisters) that rupture to leave a thin, varnish-like crust, rather than the thick honey-colored crusts seen here. - It is exclusively caused by **Staphylococcus aureus** strains producing exfoliative toxins. *Ritter disease* - Also known as **Staphylococcal Scalded Skin Syndrome (SSSS)**, this condition involves widespread **erythema and exfoliation** resembling a burn. - It is a severe, systemic illness with widespread skin involvement, not localized crusted lesions like those pictured. *Ecthyma* - This is a more **deep-seated skin infection** that penetrates into the dermis, characterized by **"punched-out" ulcers** with thick, adherent crusts and often leaves scars. - While also caused by *Staphylococcus aureus* and/or *Streptococcus pyogenes*, its lesions are typically more severe and destructive than what is depicted. [Practice more Dermatology PYQs on OnCourse]

Question 1

Most common subtype of Rodent ulcer is:

Accepted Answer

Nodular

Answer

Superficial

Answer

Pigmented

Answer

Cystic

Question 2

What are these horizontal lines seen on the skin called?

Accepted Answer

Blaschko lines

Answer

Dermatomes

Answer

Vascular development

Answer

Lymphatic development

Question 3

All of the following are manifestations of congenital syphilis except:-

Accepted Answer

Gumma

Answer

Olympian brow

Answer

Interstitial keratitis

Answer

Hutchinson's teeth

Question 4

A child presents with the skin lesions shown in the image. The most likely diagnosis is:

Accepted Answer

Impetigo contagiosa

Answer

Bullous impetigo

Answer

Ritter disease

Answer

Ecthyma

FMGE 2018 — Dermatology