- Multiple, shiny, pinhead size papules on dorsal surface of hand, forearm & penis in young boy
a) Scabies
b) Lichen planus
c) Lichen nitidus
d) Molluscum contagiosum
Ans: Lichen nitidus
Explanation:
Lichen nitidus:
Lichen nitidus is a relatively rare, chronic skin eruption that is flat-topped, skin-colored micro-papules (Pinpoint to pinhead size). Lichen nitidus mainly affects children and young adults.
The most common sites of involvement are the trunk, flexor aspects of upper extremities, dorsal aspects of hands, and genitalia.
Lichen nitidus is usually an asymptomatic eruption; however, patients occasionally complain of pruritus.
- 37 year female with itchy linear wheal, with itching for 30 minutes at site, diagnosis is
a) Dermatographic urticaria
b) Pressure urticaria
c) Acute urticaria
d) Chronic urticaria
Ans: Dermatographic urticaria
Explanation:
The term dermographism (or dermatographism) literally means writing on the skin. It is the commonest form of physical urticaria. Firm stroking of the skin produces a linear wheal. Whealing usually develops within 5-10 minutes of stroking the skin and persists for 15-30 minutes.
- Treatment of choice of comedone lesions on face trunk
a) Retinoids
b) Clindamycin
c) Retinoids plus oral doxycycline
d)
Answer: Retinoids plus oral doxycycline
Explanation:
Comedonal acne: It forms because a component of skin oil called sebum along with old skin cells block the pores of the skin. Comedonal acne appears most often on the forehead, nose, and chin.
The most common treatment is retinoids with an oral antibiotic, such as doxycycline, tetracycline, minocycline or erythromycin, which kills the bacteria that cause inflammation around the blocked pores.
Topical retinoids are comedolytic and anti-inflammatory. They normalize follicular hyper-proliferation and hyper-keratinization. Topical retinoids reduce the numbers of micro-comedones, comedones, and inflammatory lesions.
- Most common association with coarse pitting of nails and onycholysis
a) Violaceous papules
b) Dermal Plaques
c) Scaly plaques
d) Alopecia areata
Answer: Scaly plaques
Explanation:
Alopecia areata: Fine pitting, roughness of nail surface
Darier’s disease: Longitudinal ridges, triangular nicks at distal nail edge
Eczema: Coarse pitting, transverse ridging, dystrophy, shiny nails due to rubbing
Lichen planus: Thinned nail plate, longitudinal grooves, adhesion between distal nail fold and nail bed (pterygium), complete nail loss
Psoriasis: Pitting, nail thickening, onycholysis (separation of nail from nail bed), brown discoloration, sub-ungual hyperkeratosis
Lichen planus: violaceous papules
Psoriasis: Scaly plaques