Basic Dermatology Practice Questions

Q: Pseudo Nikolsky sign is seen in all except:

Erythema Multiforme. ***Erythema Multiforme*** - Erythema multiforme is an acute, self-limiting inflammatory dermatosis, and it typically does not present with a **Pseudo Nikolsky sign** as its lesions are usually fixed or have minimal epidermal involvement. - The disease is characterized by target lesions, often in response to infections (e.g., herpes simplex virus) or drugs, with **subepidermal blistering** in some cases but usually without extensive epidermal detachment. *Toxic epidermal Necrolysis* - **Toxic epidermal Necrolysis (TEN)** is a severe mucocutaneous reaction characterized by widespread **epidermal detachment**, making the Nikolsky sign and Pseudo Nikolsky sign positive due to extensive skin fragility and epidermal loss. - This condition involves full-thickness epidermal necrosis, leading to blistering and sloughing of skin that resembles a **severe burn**. *Stevens Johnson Syndrome* - **Stevens-Johnson Syndrome (SJS)** is a less severe form of TEN, but it also features **epidermal detachment** and usually has a positive Nikolsky sign, and therefore also a Pseudo Nikolsky sign. - It involves smaller body surface area detachment compared to TEN but still demonstrates significant epidermal damage and skin fragility. *Staphylococcal scalded skin syndrome* - In **Staphylococcal scalded skin syndrome (SSSS)**, toxins produced by *Staphylococcus aureus* specifically target **desmoglein-1**, causing superficial epidermal splitting and a prominent positive Nikolsky sign (and Pseudo Nikolsky sign). - This condition results in widespread **flaccid blisters** and exfoliation, particularly in children, without full-thickness epidermal necrosis.

Q: The following skin condition is associated with:

Diabetes. ***Diabetes*** - The image displays characteristics of **necrobiosis lipoidica**, a skin condition strongly associated with **diabetes mellitus**. - Necrobiosis lipoidica typically presents as **shiny, atrophic plaques with distinct red or violaceous borders and a yellow-brown center**, often on the shins, as seen in the image. *Hyperthyroidism* - This condition is associated with **pretibial myxedema**, which presents as non-pitting edema and thickened, discolored skin, distinct from the atrophic plaques shown. - Other dermatological manifestations include **onycholysis** (Plummer's nails), fine hair, and generalized hyperpigmentation, none of which are consistent with the image. *Hypothyroidism* - Hypothyroidism is associated with **generalized myxedema**, which results in dry, coarse, cold skin, and facial puffiness. - It does not typically cause the **atrophic, yellow-brown plaques** characteristic of the presented skin lesion. *Sarcoidosis* - Sarcoidosis can cause various skin lesions, including **erythema nodosum**, lupus pernio, and subcutaneous nodules. - These lesions have distinct appearances that do not match the **necrobiosis lipoidica** depicted in the image.

Q: The skin condition shown in the image is associated with?

Diabetes mellitus. ***Diabetes mellitus*** - The image shows **diabetic dermopathy** (also known as "shin spots"), which presents as hyperpigmented, atrophic macules or papules, usually on the shins. This condition is a common cutaneous manifestation of **diabetes mellitus**. - Other dermatological conditions associated with diabetes include **necrobiosis lipoidica diabeticorum**, **acanthosis nigricans**, and **erythrasma**, which are important to recognize in patients with diabetes. *Hypothyroidism* - Hypothyroidism is associated with **myxedema**, which typically manifests as non-pitting edema, dry and coarse skin, and hair loss. - While it can cause skin changes, it does not typically present with the pigmented, atrophic lesions seen in the image. *Hyperthyroidism* - Hyperthyroidism can cause skin changes such as **pretibial myxedema** (a specific form of localized skin thickening, typically on the shins, that is often associated with Graves' disease) and warm, moist skin due to increased metabolism. - The lesions shown in the image are not consistent with the typical presentation of pretibial myxedema or other hyperthyroid skin manifestations. *Sarcoidosis* - Sarcoidosis can present with various skin lesions, including **erythema nodosum**, lupus pernio, plaques, and papules. - The skin changes seen in the image, characterized by small, atrophic, hyperpigmented macules, do not fit the typical pattern of cutaneous sarcoidosis.

Q: The following image shows:

Wood's lamp. ***Wood's lamp*** - The image clearly displays a device with **ultraviolet (UV) light bulbs** (blue tubes) and a magnifying lens, which is characteristic of a Wood's lamp. - A Wood's lamp is used in dermatology to detect various skin conditions by observing the **fluorescence** of certain substances under UV light. *Infrared lamp* - An infrared lamp produces **heat** and is typically used for therapeutic purposes such as pain relief, not for diagnostic skin examination using UV fluorescence. - Its appearance would involve a bulb that emits visible red light and heat, not the distinct blue UV tubes seen here. *Slit lamp* - A slit lamp is a **biomicroscope** used in ophthalmology to examine the anterior segment and posterior segment of the human eye. - It consists of a light source that can be focused into a narrow slit and a binocular microscope, which looks completely different from the device pictured. *Thermoprobe* - A thermoprobe is a device used to measure **temperature**, often a small probe with a digital readout. - It has no magnifying capabilities or UV light sources, making it distinct from the instrument shown in the image.

Q: The following image shows:

Acantholytic cell. ***Acantholytic cell*** - The image displays characteristics of an **acantholytic cell**, particularly with its **rounder shape** and visible nucleus, surrounded by a distinct halo or separated from adjacent cells. - These cells result from the loss of cohesion between **keratinocytes** due to the breakdown of desmosomes, a hallmark feature in conditions like **Pemphigus vulgaris**. *Acanthocyte* - An **acanthocyte** is a red blood cell with **spiculated projections** (thorn-like processes) on its surface, often seen in liver disease or abetalipoproteinemia. - The cell in the image does not resemble a red blood cell and lacks the characteristic spiky projections. *Acanthosis* - **Acanthosis** refers to the **thickening of the stratum spinosum** (prickle cell layer) in the epidermis. - This is a **histopathological finding** visible at a tissue level, not a characteristic of an individual cell. *Anaplastic cell* - An **anaplastic cell** is typically a **highly undifferentiated malignant cell** with features like pleomorphism, prominent nucleoli, and abnormal mitotic figures. - While these cells can be irregular, the cell in the image specifically points to loss of intercellular adhesion rather than general cellular malignancy and dedifferentiation.

Q: The image shows a child with?

Ehlers-Danlos syndrome. ***Ehlers-Danlos syndrome*** - The image demonstrates extreme **skin hyperextensibility**, a hallmark feature of **Ehlers-Danlos syndrome** (EDS), a group of inherited connective tissue disorders. - This unusual elasticity is due to defects in **collagen synthesis** or processing, leading to fragile and hyperelastic skin. *Cutis laxa* - Characterized by **loose, sagging, and inelastic skin** that hangs in folds, giving a prematurely aged appearance, which is different from the extreme stretchiness seen in the image. - The skin in cutis laxa appears "too large for the body" and does not recoil quickly after stretching. *Marfan syndrome* - Primarily affects the skeletal, ocular, and cardiovascular systems, presenting with features like **tall stature, long limbs and fingers (arachnodactyly)**, and lens dislocation. - While it is a connective tissue disorder, **skin hyperextensibility** is not a prominent or diagnostic feature of Marfan syndrome. *Ataxia-telangiectasia* - A rare, neurodegenerative, inherited disease characterized by **progressive cerebellar ataxia**, **oculocutaneous telangiectasias**, and immunodeficiency. - Skin elasticity is not affected, and the clinical presentation is dominated by neurological symptoms and recurrent infections.

Q: A 30-year-old woman presents with a cosmetic complaint shown in the image. What is the clinical diagnosis?

Xanthelasma. ***Xanthelasma*** - The image shows **yellowish, plaque-like lesions** on the **eyelids**, which are characteristic of xanthelasma. These lesions are **deposits of cholesterol** within macrophages in the skin. - Xanthelasma is often associated with **dyslipidemia**, though it can also occur in individuals with normal lipid levels. *Necrobiosis lipoidica* - This condition typically presents as **sharply demarcated, yellowish-brown plaques** with an atrophic, waxy center, often on the **shins**. - It is frequently associated with **diabetes mellitus** and does not typically involve the eyelids in this manner. *Tuberous xanthoma* - Tuberous xanthomas are **firm, painless nodules** that typically appear over **extensor surfaces** such as elbows, knees, and Achilles tendons. - They are also fat deposits but differ in morphology and location from the eyelid lesions seen here. *Orbital lipogranuloma* - An orbital lipogranuloma is an **inflammatory mass within the orbit** that can cause proptosis or swelling around the eye. - It is an internal orbital mass, not a superficial skin lesion on the eyelids as depicted.

Q: All are causes of following tongue appearance except: (Recent NEET Pattem 2016-17)

HIV. ***HIV*** - The image shows a **fissured tongue**, which is characterized by **grooves and furrows** on the dorsal surface of the tongue. - While other conditions can cause a fissured tongue, **HIV** itself is *not* considered a direct cause of this specific tongue morphology. Oral manifestations of HIV typically include **candidiasis**, **hairy leukoplakia**, or Kaposi's sarcoma. *Melkersson-Rosenthal syndrome* - This syndrome is characterized by a triad of **relapsing facial paralysis**, **persistent orofacial swelling**, and a **fissured tongue**. - Therefore, a fissured tongue is a recognized clinical feature of Melkersson-Rosenthal syndrome. *Down syndrome* - Individuals with Down syndrome (Trisomy 21) frequently present with various oral manifestations, including a **fissured tongue** (also known as scrotal tongue or plicated tongue). - This is a common and characteristic finding in this genetic condition. *Genetic basis* - A **fissured tongue** can have a **genetic predisposition** and may occur as an isolated familial trait. - It can be inherited as an **autosomal dominant trait** and is often seen without any associated syndromic conditions.

Q: The image shows presence of:

Black hairy tongue. ***Black hairy tongue*** - The image clearly displays an elongated and discolored appearance of the **filiform papillae** on the dorsal surface of the tongue, consistent with **black hairy tongue**. - This condition is characterized by an accumulation of **keratin** and the overgrowth of bacteria or fungi, leading to the characteristic "hairy" and often discolored (dark brown to black) appearance. *Leukoplakia* - Leukoplakia typically presents as **white patches** or plaques on the mucous membranes that cannot be scraped off and are not attributable to any other disease. - Unlike the image, it does not involve the elongation of filiform papillae and generally lacks the "hairy" texture. *Geographical tongue* - **Geographical tongue**, also known as benign migratory glossitis, is characterized by migrating, irregularly shaped **red lesions** surrounded by raised white or yellowish borders. - These lesions represent areas of **atrophy of the filiform papillae** and appear smooth and depapillated, which is in contrast to the elongated papillae seen in the image. *Median rhomboid glossitis* - **Median rhomboid glossitis** is a well-demarcated, often **erythematous** (reddish) and sometimes lobulated or nodular lesion located in the **midline of the dorsal tongue**, anterior to the circumvallate papillae. - It is typically characterized by the **absence of filiform papillae** in the affected area, presenting a smooth or nodular surface, which differs from the widespread elongated papillae in the image.

Q: Identify the lesion seen on the tongue in the given image.

Geographic tongue. ***Geographic tongue*** - The image distinctly shows **irregular, red patches** on the dorsal surface of the tongue, surrounded by a **white or yellowish border**. - These patches represent areas of **atrophy of the filiform papillae**, which migrate and resolve spontaneously, giving the tongue a "map-like" appearance. *Black hairy tongue* - Characterized by the **elongation and hypertrophy of the filiform papillae**, leading to a hair-like appearance, often **dark-stained** due to trapped debris or chromogenic bacteria. - The image does not show elongated or discolored papillae; instead, there are smooth, reddened areas. *Stevens-Johnson syndrome* - A **severe mucocutaneous reaction**, often triggered by medications, presenting with extensive **vesicles, bullae, and erosions** on mucous membranes and skin. - The image shows localized tongue findings typical of inflammation, not widespread skin sloughing or blistering. *Acrodermatitis enteropathica* - A rare genetic disorder causing **zinc deficiency**, leading to a classic triad of **dermatitis**, **diarrhea**, and **alopecia**. - Oral findings can include stomatitis and glossitis, but the characteristic rash is typically periorificial and acral, and the image does not show general signs of zinc deficiency.

Question 1

Pseudo Nikolsky sign is seen in all except:

Accepted Answer

Erythema Multiforme

Answer

Toxic epidermal Necrolysis

Answer

Stevens Johnson Syndrome

Answer

Staphylococcal scalded skin syndrome

Question 2

The following skin condition is associated with:

Accepted Answer

Diabetes

Answer

Hyperthyroidism

Answer

Hypothyroidism

Answer

Sarcoidosis

Question 3

The skin condition shown in the image is associated with?

Accepted Answer

Diabetes mellitus

Answer

Hypothyroidism

Answer

Hyperthyroidism

Answer

Sarcoidosis

Question 4

The following image shows:

Accepted Answer

Wood's lamp

Answer

Infrared lamp

Answer

Slit lamp

Answer

Thermoprobe

Question 5

The following image shows:

Accepted Answer

Acantholytic cell

Answer

Acanthocyte

Answer

Acanthosis

Answer

Anaplastic cell

Question 6

The image shows a child with?

Accepted Answer

Ehlers-Danlos syndrome

Answer

Cutis laxa

Answer

Marfan syndrome

Answer

Ataxia-telangiectasia

Question 7

A 30-year-old woman presents with a cosmetic complaint shown in the image. What is the clinical diagnosis?

Accepted Answer

Xanthelasma

Answer

Necrobiosis lipoidica

Answer

Tuberous xanthoma

Answer

Orbital lipogranuloma

Question 8

All are causes of following tongue appearance except: (Recent NEET Pattem 2016-17)

Accepted Answer

HIV

Answer

Melkersson-Rosenthal syndrome

Answer

Down syndrome

Answer

Genetic basis

Question 9

The image shows presence of:

Accepted Answer

Black hairy tongue

Answer

Leukoplakia

Answer

Geographical tongue

Answer

Median rhomboid glossitis

Question 10

Identify the lesion seen on the tongue in the given image.

Accepted Answer

Geographic tongue

Answer

Black hairy tongue

Answer

Acrodermatitis enteropathica

Answer

Stevens-Johnson syndrome

Basic Dermatology — MCQs

Basic Dermatology — MCQs

On this page

Practice by Chapter

Want unlimited practice?