Dermatology quiz

https://geekymedics.com/dermatology-
quiz/
1. Which one of the following can develop into squamous cell carcinoma over time?

(A) Onychomycosis
(B) Actinic keratosis*
(C) Seborrheic keratosis
(D) Psoriasis
(E) Impetigo

Question 1
WRONG

How does lichen planus present clinically?

A Salmon coloured plaques with silvery scale

Pruritic, red, oozing rash with edema

C Golden coloured crusts

Pruritic, purple, polygonal, planar papules and plaques
Question 1 Explanation:
Learn the 6 P’s of lichen planus. It also often occurs with reticular white
lines on the mucosal surfaces (Wickham striae). There is an association
with hepatitis C.
Question 2
WRONG
What type of melanoma is often seen in dark skinned individuals?

A Superficial spreading
Lentigo maligna melanoma

C Nodular
Acral lentiginous
Question 2 Explanation:
The acral lentiginous variant of melanoma arises in dark skinned
individuals on their palms or soles. It is not linked to UVB induced DNA
damage unlike the other types (this was the disease that caused the death
of Bob Marley).
Question 3
 WRONG
How does impetigo present?
Golden honey coloured crust over an erythematous base
Salmon coloured plaque with silvery scale

C Comedones, pustules and nodules

D Flesh coloured papule with a rough surface
Question 3 Explanation:
Impetigo is a superficial skin infection caused by Staph aureus or Strep
pyogenes. It frequently affects children. It is treated with penicillin and
topical preparations e.g. mupirocin.
Question 4
WRONG
What skin condition is caused by poxvirus?

A Verruca
Molluscum contagiosum
Impetigo

D Cellulitis
Question 4 Explanation:
Molluscum contagiosum is an umbilicated papule. It is commonly seen in
children and sexually transmitted in adults.
Question 5
WRONG
What is the most common mole found in adults?
Junctional nevus

B Compound nevus
Intradermal nevus

D Congenital nevus
Question 5 Explanation:
A mole/nevus is a benign neoplasm of melanocytes. It can be congenital or
acquired. If acquired, it progresses from a junctional nevus (most common
in children) to a compound nevus and eventually to an intradermal nevus.
Note that the mole can undergo dysplasia and the dysplastic nevus is a
precursor to melanoma.
Question 6
WRONG
What is the infective agent implicated in acne?

A Staphylococcus aureus
B Streptococcus pyogenes
 Staphylococcus epidermidis
Propionibacterium acnes
Question 6 Explanation:
Propionibacterium acnes infection produces lipases resulting in
inflammation and breakdown of sebum, leading to pustule formation.
Question 7
WRONG
What disease is associated with dermatitis herpetiformis?
Herpes
Coeliac disease

C Atopic dermatitis
D Melanoma
Question 7 Explanation:
In coeliac disease, there are IgA antibodies against gluten that cross react
with reticulin fibres that anchor the basement membrane to the dermis.
Thus, IgA is deposited at the tips of dermal papillae, presenting as grouped
pruritic vesicles, papules or bullae. Usually found on elbows.
Question 8
WRONG
What is a precursor to squamous cell carcinoma (SCC)?

A Keratoacanthoma
Actinic keratosis

C Leser-Trélat sign
Measles
Question 8 Explanation:
Actinic keratosis is a premalignant lesion to SCC, caused by prolonged sun
exposure. It presents as scaly, rough, erythematous and small plaques,
most commonly on the face, back or neck.
Question 9
WRONG
What condition is associated with acanthosis nigricans?
Type 2 diabetes and gastric adenocarcinoma

B Rubella
C Varicella zoster
Basal cell carcinoma
Question 9 Explanation:
Acanthosis nigricans is epidermal hyperplasia with darkening of the skin,
especially in the axilla, neck or groin. It is associated with malignancy
especially GIT adenocarcinoma or insulin resistance as seen in type 2
diabetes and metabolic syndrome.
Question 10
Do people with albinism have an increased risk of skin cancer?

A True

B False
Question 11
WRONG
What is Leser-Trélat sign?
Sudden appearance of multiple seborrheic keratosis and is an indicator of a gastrointestinal tract
carcinoma.

B A left supraclavicular node associated with gastric carcinoma

C Metastasis of gastric carcinoma to the periumbilical region
Metastasis of gastric carcinoma to the bilateral ovaries
Question 11 Explanation:
Note that the presentation of gastric carcinoma can include Leser-Trélat
sign, Virchow node, Sister Mary Joseph nodule and Krukenberg tumour.
Question 12
CORRECT
What childhood infection is associated with Koplik spots?
Measles

B Rubella
C Varicella
D Fifth disease
Question 12 Explanation:
Measles is a paramyxovirus. Koplik spots are small bright red spots with a
white centre on the buccal mucosa that precede the measles rash by 1-2
days and are pathognomonic for measles. Measles present initially with
cough, coryza and conjunctivitis then the Koplik spots. Eventually a
maculopapular rash develops, beginning at the head/neck and spreading
downwards.
Question 13
WRONG
What disorder is characterised by an initial ‘herald patch’ which is then
followed by scaly erythematous plaques usually in a ‘Christmas tree’
distribution?
Pityriasis rosea
Herpes

C Varicella zoster virus

D Erysipelas
Question 13 Explanation:
Pityriasis rosea classically presents with a salmon coloured solitary patch
‘herald patch’ which enlarges over a few days followed by generalised
bilateral and symmetric macules with collarette scale. Pruritus is
sometimes present. It self resolves within 6 – 8 weeks.
Question 14
WRONG
An elderly lady presents to her doctor with a raised, round discoloured
plaque, ‘stuck on appearance’ on her face. What skin condition is this?

A Rubella
Seborrheic keratosis
Basal cell carcinoma

D Melasma
Question 14 Explanation:
Seborrheic keratosis is a benign squamous proliferation and is seen
frequently in the elderly.
Question 15
WRONG
What is the pathogenesis of vitiligo?

A Congenital lack of pigmentation

Increase in the number of melanosomes
Autoimmune destruction of melanocytes

D Benign proliferation of melanocytes

Question 15 Explanation:
Vitiligo is the localised loss of skin pigmentation due to the autoimmune
destruction of melanocytes. Melanocytes synthesise melanin in
melanosomes. Thus, if melanocytes are destroyed, melanin cannot be
produced.
Question 16
WRONG
What is the best indicator of prognosis for a melanoma?

A Asymmetry
B Colour
Diameter
Invasion of the dermis
Question 16 Explanation:
Invasion/ depth of extension measured by Breslow thickness is the most
significant prognostic factor in predicting metastasis. Asymmetry, border
irregularity, colour variation and diameter (>6mm) are known as the ‘ABCD’
criteria for describing melanomas.
Question 17
WRONG
What are the histological findings of psoriasis?

A Inflammation of the dermal-epidermal junction

Peripheral palisading of basal cells
Acanthosis, Parakeratosis and Munro microabscesses

D Keratin pseudocysts
Question 17 Explanation:
Psoriasis is as a result of increased keratinocyte proliferation. It presents
as salmon coloured papules and plaques with silvery scaling, especially on
extensor surfaces and scalp. On histology, there is epidermal hyperplasia
(acanthosis), hyperkeratosis with retention of nuclei in stratum corneum
(parakeratosis) and groups of neutrophils in the stratum corneum (Munro
microabscesses).
Question 18
WRONG
What condition is associated with this presentation? – A pink pearly nodule
with telangiectasias, ulceration and rolled borders on the upper lip.

A Squamous cell carcinoma

Basal cell carcinoma

C Melanoma
Eczema

Question 18 Explanation:
This is a classical presentation of basal cell carcinoma, a malignant
proliferation of basal cells and the most common skin cancer. Risk factors
include excessive sunlight exposure, xeroderma pigmentosum and
albinism. Treatment is surgical

excision.
Question 19
WRONG
What is the most common causative agent of erythema multiforme (EM)?

A Penicillin and sulphonamides

Systemic lupus erythematosus
B
 HSV infection

Malignancy
Question 19 Explanation:
HSV is the most common etiologic agent of EM, which presents as a
targetoid rash and bullae. All the other options are also associated with
the disorder, but less commonly.
Question 20
What is the pathogenesis of pemphigus vulgaris?

A IgG antibody against desmoglein

B IgG antibody against hemidesmosome components
C Autoimmune deposition of IgA at tips of dermal papillae
D Enzyme defect in tyrosinase