Last 5 year PYQs in Dermatology for NEET PG

 Q1. Please determine the medication utilized for the management of the presented medical condition:​

1. Anti-fungal therapy
2. Anti-tubercular therapy
3. Topical steroids therapy
4. Anti-leprosy treatment

Ans. 2) Anti-tubercular therapy

• The image shows annular plaque with central scarring which is suggestive of Lupus vulgaris, a form of cutaneous tuberculosis caused by Mycobacterium tuberculosis infection. It presents as a chronic, slowly progressive skin lesion with an annular (ring-shaped) plaque and central scarring.
• Anti-tubercular therapy: Anti-tubercular therapy is the treatment of choice for lupus vulgaris. It consists of a combination of drugs, including isoniazid, rifampicin, ethambutol, and pyrazinamide. These medications target Mycobacterium tuberculosis, the causative organism, and aim to eradicate the infection.

Q2. Identify the finding associated with the condition shown in the image below:​

1. Isomorphic phenomenon
2. Meyerson phenomenon
3. Gottron’s papule
4. Nikolsky’s sign

Ans. 1) Isomorphic phenomenon

• The above image depicts pustular psoriasis, which is a chronic inflammatory skin condition characterized by well-demarcated, erythematous plaques covered with silvery-white scales.
• Isomorphic phenomenon: The isomorphic phenomenon is the correct finding associated with the image. In individuals with psoriasis, new psoriatic lesions can appear at sites of skin trauma, such as scratches, cuts, or other forms of injury.

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Q3.  Identify the finding shown in the image below:​

1. Herpes labialis
2. Herpangina
3. Molluscum contagiosum
4. Impetigo

Ans. 1) Herpes labialis

• Herpes labialis, commonly known as cold sores or fever blisters, is a viral infection caused by the herpes simplex virus type 1 (HSV-1). The characteristic presentation of multiple vesicles and crusts clustered on an inflamed base around the lips is indicative of a herpes simplex virus infection. Recurrent outbreaks are common, often triggered by factors such as stress, sun exposure, or fever.

Q4. Which of the morpholine drugs listed below is used as a nail lacquer?

1. Amorolfine
2. Oxiconazole
3. Ciclopirox olamine
4. Tioconazole

Ans. 1) Amorolfine

• Amorolfine is an antifungal medication that belongs to the class of drugs known as morpholines. It is commonly used as a topical nail lacquer for the treatment of fungal infections of the nails, known as onychomycosis. Amorolfine works by inhibiting the growth of fungi, including dermatophytes and yeasts, which are responsible for causing nail infections.​

Q5. Which of the following is the most probable diagnosis for a child born with membranes around the body, ectropion, and eclabium, presenting with lesions on the face, trunk, and extremities, and brought to the OPD?​​

1. Harlequin ichthyosis
2. Lamellar ichthyosis
3. Bathing suit ichthyosis
4. Ichthyosis vulgaris

Ans. 1) Harlequin ichthyosis

• Harlequin ichthyosis is likely a diagnosis based on the symptoms described. 

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​Q6. A 10-year-old boy presented with mild, painful swelling over the scalp for 3 months, as depicted below. Additionally, the patient confirms having a pet dog in his household. What is the most appropriate diagnosis of this condition?​

1. Furuncle
2. Epidermoid cyst
3. Kerion
4. Folliculitis

Ans. 3) Kerion

The most likely diagnosis for the condition is kerion.

• Kerion is a type of fungal infection of the scalp known as tinea capitis, which is caused by dermatophytes, particularly the fungus Trichophyton species.
• Patients with kerion usually present with symptoms such as tender, painful, boggy scalp swelling, redness, tenderness, and sometimes discharge.
• Kerion can be both inflammatory, where scarring hair loss is seen, or non - inflammatory, where non-scarring hair loss is seen. The affected area may also have pustules and crusts.
• The child has a pet dog at home, which can carry the dermatophyte fungus on their skin and hair and can be transmitted to humans. It is commonly seen in children.

 Q7. A child with a history of nightblindness presented to you with the following findings. What is the diagnosis?​

1. Phrynoderma
2. Keratosis pilaris
3. Darier disease
4. Follicular eczema

Ans. 1) Phrynoderma

• Phrynoderma is the most likely diagnosis for the child with a history of night blindness and the presented findings.
• Phrynoderma is a skin condition characterized by small follicular bumps and thickening of the outer layer of the skin (hyperkeratosis) in a symmetrical pattern.
• Phrynoderma (toad skin):
  • Mixed deficiency of vitamin A, B, D, E, and essential fatty acids.
  • Asymptomatic hyperkeratotic rough papules on elbows and knees
• Phrynoderma is commonly seen in children and malnourished individuals. The condition typically presents as small, rough bumps on the outer arms, thighs, buttocks, and cheeks.

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Q8. What is the probable diagnosis for a 30-year-old patient who has presented with flaccid bullae on her skin that are prone to easy rupture, with the biopsy showing a suprabasal split?

1. Pemphigus vulgaris
2. Pemphigus foliaceus
3. Pemphigus vegetans
4. Erythema multiforme

Ans. 1) Pemphigus vulgaris

• The most likely diagnosis for the 30-year-old patient with flaccid bullae that are easy to rupture and a biopsy revealing a suprabasal split is Pemphigus vulgaris.
  • Pemphigus vulgaris is an autoimmune blister disorder that usually affects the skin and mucous membranes.
  • It is characterized by flaccid bullae, large, fragile blisters that easily rupture, leaving painful erosions behind.
  • The blister is seen in the lower portion of the epidermis. The bullae are formed due to the loss of cohesion between skin cells due to the breakdown of intercellular bridges, a process called acantholysis.
  • In pemphigus vulgaris, the acantholysis occurs in the suprabasal layer of the epidermis, resulting in a suprabasal split on biopsy.

Q9. What is the treatment of choice for a patient with paronychia, as shown in the image below?​

1. Amoxiclav
2. Metronidazole
3. Amikacin
4. Norfloxacin

Ans. 1) Amoxiclav

• Paronychia is a painful red swelling due to an infection of the nail fold.
• The patient usually complains of pain in the fingernail, and on examination, a red nail fold with pus discharge is seen.
• Amoxiclav contains amoxicillin, a penicillin-like antibiotic, and clavulanic acid, a beta-lactamase inhibitor.

Q10. What would be your next best course of action when a patient undergoing multi-drug therapy (MDT) exhibits deterioration of preexisting lesions and nerve involvement?

1. Stop MDT, start systemic corticosteroids
2. Continue MDT, start systemic steroids
3. Stop MDT thalidomide
4. Continue MDT, start thalidomide

Ans. 2) Continue MDT, start systemic steroids

• MDT should not be stopped if a patient develops a lepra reaction during therapy
• Multi-drug therapy is the treatment given for all leprosy patients.
• It is the treatment of choice according to the WHO leprosy classification; a combination of drugs is given daily.
• This is called multi-drug therapy, and rifampicin, dapsone, and clofazimine are used in this therapy.
• Two regimens are followed: PB-MDT for paucibacillary and MB-MDT for multibacillary patients.

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 Q11. A patient presents to you with multiple anogenital warts. The biopsy of these lesions showed squamous atypia. Which of the following human papillomavirus types are considered high-risk?​

1. HPV 2
2. HPV 18
3. HPV 6
4. HPV 11

Ans. 2) HPV 18

• Human papillomavirus (HPV) is a group of viruses that can cause warts on the skin or mucous membranes of the body.
• Squamous atypia can be a precursor to cancer in a few cases.
• The high-risk strains of HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68.

Q12. A farmer presents to you with swelling on foot and multiple discharging sinuses in the lower limb. Granules from the discharge were examined under the microscope, shown below. Which of the following is true regarding this condition?​

1. Both bacteria and fungi can be causative
2. Undergoes lymphatic spread
3. There is lymphocyte accumulation
4. Involves only superficial tissues

Ans. 1) Both bacteria and fungi can be causative

• The given description is suggestive of mycetoma, which is a chronic, progressive, and damaging infection of the skin, subcutaneous tissues, and bones caused by bacteria or fungi. 
• The granules seen in the discharge under the microscope are characteristic of mycetoma, which can be eumycetoma (contagious) or actinomycetoma (bacterial). Hence, the correct option is that bacteria and fungi can be causative in mycetoma.

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Q13. What is the probable diagnosis for a cauliflower-shaped mass on the foot of a farmer that appeared after a minor injury, with microscopy revealing copper penny bodies?

1. Chromoblastomycosis
2. Blastomycosis
3. Sporotrichosis
4. Phaeohyphomycosis

 Ans. 1) Chromoblastomycosis

• The cauliflower-shaped mass on foot with copper penny bodies seen on microscopy is a characteristic presentation of chromoblastomycosis, a persistent fungal disease of the skin and subcutaneous tissues caused by a few diverse species of pigmented fungi. 

• The condition ordinarily develops after a minor injury and presents as a verrucous or cauliflower-like injury that gradually develops and becomes more extensive. The copper penny bodies, or sclerotic bodies, are a disease hallmark and represent aggregates of fungal cells inside the tissue.

Q14. Irregular pitting of nails with subungual hyperkeratosis is seen in ___________.​

1. Lichen planus
2. Psoriasis
3. Atopic dermatitis
4. Alopecia areata

Ans. 2) Psoriasis

• Irregular pitting of nails with subungual hyperkeratosis is a characteristic highlight of nail psoriasis. Nail psoriasis is a common sign of psoriasis, a persistent inflammatory skin condition that influences 2-3% of the common population.
• The nail changes in psoriasis can incorporate pitting, onycholysis, subungual hyperkeratosis, and nail plate crumbling.

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​Q15. A 35-year-old woman presents to you with hair loss for the past three months. She tested positive for COVID-19 eight months ago. What is the most likely diagnosis?

1. Tinea capitis
2. Telogen effluvium
3. Trichotillomania
4. Female pattern androgenetic alopecia

Ans. 2) Telogen effluvium

• Telogen effluvium (TE) is a type of hair loss that happens when there's a disturbance within the typical hair development cycle, driving to more hair follicles than normal entering the resting (telogen) phase and inevitably falling out. 
• This occurs as diffuse hair shedding all over the scalp and usually occurs 2-3 months after the activating event.
• In this case, the triggering event might be the patient's COVID-19 disease 8 months ago. Various physical and emotional stressors, including sickness, surgery, childbirth, and emotional trauma, can activate telogen effluvium.

Q16. A 15-year-old girl presents with itchy lesions on her arm, as shown. Her family history is positive for asthma. What could be the most probable diagnosis?​

1. Seborrhoeic dermatitis
2. Atopic dermatitis
3. Allergic contact dermatitis
4. Erysipelas

Ans. 2) Atopic dermatitis

• Atopic dermatitis is a chronic inflammatory skin condition characterized by itchy, red, and inflamed skin lesions. It commonly affects individuals with a family history of asthma, allergic rhinitis, or atopic dermatitis.

Q17. Bindi Leucoderma is caused by which chemical?

1. A Mono-benzyl ether of Hydroquinone (MBH)
2. Crocein Scarlet MOO and Solvent Yellow 3
3. p-phenylenediamine (PPD)
4. Para Tertiary butylphenol (PTBP)

Ans. 4) Paratertiary butylphenol (PTBP)

• Bindi leukoderma, also known as "sticker dermatitis," is caused by the adhesive used in bindis, particularly the chemical PTBP.
• PTBP is a sensitizing agent that can induce an allergic reaction in some individuals, leading to depigmentation or leucoderma in the area where bindis are applied.

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Q18. What is the most frequently encountered cause of the condition shown in the image below?​

1. Vaccination
2. Malignancy
3. Drugs
4. Infection

Ans. 4) Infection

• In the case of erythema multiforme, the most common triggering factor is infection.
• Erythema multiforme is a skin condition characterized by target-like lesions, typically affecting the extremities, mucous membranes, and sometimes the trunk.
• It is believed to be an immune-mediated reaction triggered by various factors, with infection being the most common cause.
• Infection, especially viral infections like the herpes simplex virus, is the most common triggering factor for erythema multiforme.

Q19. A young female presented with vaginal itching and green, frothy genital discharge. Strawberry vagina is seen on examination. What will be the drug of choice?

1. Doxycycline
2. Oral fluconazole
3. Metronidazole
4. Azithromycin

Ans. 3) Metronidazole

• Metronidazole is the drug of choice for the treatment of trichomoniasis. It is an antibiotic with specific activity against anaerobic organisms, including Trichomonas vaginalis.
• Treatment with metronidazole is administered as a 2 g single oral dose.​

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Q20. What is the accurate statement regarding the diagnosis made from the provided image? ​

1. ​The lesions are not infectious
2. Trigeminal dermatome is most commonly affected
3. Anterior nerve roots are more commonly involved
4. Mucous membranes within the affected dermatomes are involved

Ans. 4) Mucous membranes within the affected dermatomes are involved

• Mucous membranes within the affected dermatomes are involved: In herpes zoster, the involvement of mucous membranes within the affected dermatome is possible.
• If the dermatome affected by herpes zoster includes mucous membranes, such as the oral or genital mucosa, these areas can develop characteristic vesicles and ulcers.

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