Psoriasis Practice Questions

Q: Which of the following conditions is characterized by specific nail changes such as pitting, onycholysis, and oil spots?

Psoriasis. ***Psoriasis*** - **Psoriasis** characteristically causes several specific nail changes, including **pitting**, **onycholysis** (separation of the nail plate from the nail bed), and **oil spots** (yellow-brown discoloration resembling an oil drop under the nail). - These nail manifestations are often indicative of underlying psoriatic disease, even in the absence of extensive skin lesions. *Lichen planus* - **Lichen planus** can affect the nails, causing longitudinal ridging, thinning, and sometimes pterygium formation, but typically not pitting, onycholysis, or oil spots. - In severe cases, it can lead to permanent nail loss or scarring. *Darier disease* - **Darier disease** (keratosis follicularis) is characterized by specific nail findings such as longitudinal red and white streaks, V-shaped notching at the distal nail edge, and subungual hyperkeratosis. - It does not present with the classic triad of pitting, onycholysis, and oil spots. *Onychomycosis* - **Onychomycosis** is a fungal infection of the nail that typically causes thickening, discoloration (yellow, brown, white), and crumbling of the nail plate. - While it can cause onycholysis, it does not typically produce pitting or oil spots, which are more specific to psoriasis.

Q: Acrodermatitis continua of Hallopeau is due to which of the following?

Pustular psoriasis. ***Pustular psoriasis*** - **Acrodermatitis continua of Hallopeau** is considered a severe, chronic, and localized variant of **pustular psoriasis** that primarily affects the distal extremities, particularly the nail beds and fingertips. - It involves recurrent outbreaks of **sterile pustules** that can lead to onychodystrophy, anonychia, and bone resorption. *Zinc toxicity* - **Zinc toxicity** can cause symptoms such as nausea, vomiting, abdominal pain, and copper deficiency, but it is not linked to acrodermatitis continua of Hallopeau. - Dermatological manifestations of zinc toxicity are generally not pustular or associated with nail and digit changes seen in this condition. *Zinc deficiency* - **Zinc deficiency** can lead to acrodermatitis enteropathica, a condition characterized by periorificial and acral dermatitis, alopecia, and diarrhea. - While it involves skin involvement in similar areas, the primary lesions are **eczematous and psoriasiform**, not typically sterile pustules as seen in acrodermatitis continua. *Collodion baby* - **Collodion baby** refers to a newborn covered by a taut, shiny membrane that resembles plastic wrap, typically associated with congenital ichthyoses. - It is a specific neonatal presentation of a skin barrier defect and is not related to acrodermatitis continua of Hallopeau or pustular skin conditions.

Q: Tildrakizumab was approved in March 2018 for what indication?

Psoriasis. ***Psoriasis*** - **Tildrakizumab** (Ilumya) is an **IL-23 inhibitor** specifically approved for the treatment of **moderate to severe plaque psoriasis** in adults. - It targets the **p19 subunit of IL-23**, which plays a key role in the inflammatory cascade of psoriasis. *HIV* - HIV treatment involves **antiretroviral therapy (ART)**, which targets various stages of the viral life cycle. - Tildrakizumab has no known efficacy against **HIV infection**. *Rheumatoid arthritis* - Management of **rheumatoid arthritis** typically involves **DMARDs (disease-modifying antirheumatic drugs)**, biologics like **TNF inhibitors**, or **IL-6 inhibitors**. - While IL-23 is involved in inflammation, tildrakizumab is not indicated for **rheumatoid arthritis**. *Hepatitis C* - **Hepatitis C** is treated with direct-acting antiviral (DAA) medications that target viral enzymes. - Tildrakizumab is an immunomodulator and has no role in the treatment of **Hepatitis C**.

Q: Secukinumab is used in:

Psoriasis. ***Psoriasis*** - **Secukinumab** is a monoclonal antibody that targets **interleukin-17A (IL-17A)**, a cytokine crucial in the pathogenesis of psoriasis. - It is approved for the treatment of **moderate to severe plaque psoriasis**, psoriatic arthritis, and ankylosing spondylitis. *Colorectal carcinoma* - **Secukinumab** is not used in the treatment of colorectal carcinoma; different classes of drugs like **chemotherapy**, **targeted therapies**, and **immunotherapy** (e.g., PD-1 inhibitors for MSI-high status) are employed. - Colorectal cancer treatment focuses on blocking pathways specific to cancer cell growth and survival, not IL-17A. *Breast cancer* - **Secukinumab** has no role in the treatment of breast cancer, which is managed with therapies such as **hormonal therapy**, **chemotherapy**, **HER2-targeted therapy**, and PARP inhibitors. - Breast cancer involves distinct molecular pathways and immune responses unrelated to IL-17A. *Rheumatoid arthritis* - While **rheumatoid arthritis** is an inflammatory condition, **secukinumab** is not a primary or approved treatment for it; other biologics like **TNF inhibitors**, **IL-6 inhibitors**, or **JAK inhibitors** are commonly used. - The inflammatory cascade in rheumatoid arthritis involves different key cytokines and cellular processes compared to those targeted by secukinumab.

Question 1

Which of the following conditions is characterized by specific nail changes such as pitting, onycholysis, and oil spots?

Accepted Answer

Psoriasis

Answer

Lichen planus

Answer

Darier disease

Answer

Onychomycosis

Question 2

What is Woronoff's ring?

Accepted Answer

An annular hypopigmented ring surrounding lesions of psoriasis.

Answer

A ring of lesions seen in flexural areas when hands are rested on the trunk.

Answer

Ring-shaped pruritic lesions on the dorsum of the foot.

Answer

An annular erythematous rash around the eyes in allergic dermatitis.

Question 3

Acrodermatitis continua of Hallopeau is due to which of the following?

Accepted Answer

Pustular psoriasis

Answer

Zinc toxicity

Answer

Zinc deficiency

Answer

Collodion baby

Question 4

Tildrakizumab was approved in March 2018 for what indication?

Accepted Answer

Psoriasis

Answer

HIV

Answer

Hepatitis C

Answer

Rheumatoid arthritis

Question 5

Secukinumab is used in:

Accepted Answer

Psoriasis

Answer

Colorectal carcinoma

Answer

Breast cancer

Answer

Rheumatoid arthritis

Psoriasis — MCQs

Psoriasis — MCQs

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