1
Q
Which layer of epidermis is present only in palms and soles?
A
Stratum Lucidum - Contains refractile granules of Eleidin
2
Q
What is the epidermal turnover time in normal skin vs psoriasis?
A
Normal: 56 days; Psoriasis: 6 days
3
Q
What is the epidermal melanin unit ratio?
A
1:36 (1 melanocyte to 36 keratinocytes)
4
Q
Which cells are identified on Tzanck smear?
A
Acantholytic cells in Pemphigus, HSV, VZV
5
Q
What is Munro’s microabscess and where is it seen?
A
Neutrophils in stratum corneum - seen in PSORIASIS
6
Q
What is Pautrier’s microabscess?
A
Collection of atypical lymphocytes in epidermis - seen in Mycosis Fungoides (CTCL)
7
Q
What are Civatte bodies?
A
Apoptotic basal keratinocytes (basophilic) - seen in LICHEN PLANUS
8
Q
What is the characteristic of Birbeck granules?
A
Tennis racket/rod-shaped structures in Langerhans cells - Langerin (CD207) deposition
9
Q
Define Parakeratosis and list 4 conditions
A
Retained nuclei in stratum corneum. Seen in: Psoriasis, Squamous cell CA, Seborrheic dermatitis, Actinic keratosis
10
Q
Define Hyperkeratosis
A
Thickened stratum corneum - seen in Psoriasis, Lichen Planus
11
Q
What is Orthokeratosis? Classic example?
A
Hyperkeratosis WITHOUT parakeratosis. Classic: LICHEN PLANUS
12
Q
Histopathology of Psoriasis - 5 key features
A
- Parakeratosis 2. Agranulosis 3. Munro microabscess 4. Spongiform pustules of Kogoj 5. Club-shaped rete ridges
13
Q
Histopathology of Lichen Planus - 4 key features
A
- Hypergranulosis 2. Max-Joseph space 3. Civatte bodies 4. Lichenoid band of inflammation
14
Q
Lofgren syndrome triad
A
Erythema Nodosum + Bilateral hilar lymphadenopathy + Arthritis (Acute Sarcoidosis)
15
Q
Differentiate Pyoderma Gangrenosum in IBD vs Behcet’s
A
IBD: Responds to treatment of IBD; Behcet’s: NO response to treatment
16
Q
What causes Erythema Migrans and what is DOC?
A
Lyme disease - Borrelia burgdorferi (Ixodes tick bite). DOC: DOXYCYCLINE
17
Q
True target lesions are seen in which conditions?
A
Erythema Multiforme - HSV, Mycoplasma, Chloroquine
18
Q
List 3 conditions showing Koebner phenomenon
A
P: Psoriasis, V: Vitiligo, L: Lichen Planus
19
Q
Which type of psoriasis is linked to streptococcal infection?
A
Guttate psoriasis - treat with MACROLIDES
20
Q
What is Auspitz sign?
A
Dilated blood vessels with bleeding on removal of scales in psoriasis
21
Q
Nail changes in Psoriasis vs Alopecia Areata
A
Psoriasis: Irregular pitting, Oil droplet, Subungual hyperkeratosis; Alopecia Areata: Regular pitting
22
Q
Joint involvement in Psoriatic arthritis
A
DIP joints - ‘Pencil in cup’ deformity
23
Q
Treatment of Psoriasis <10% BSA
A
Topical Steroids
24
Q
Treatment of Psoriasis >10% BSA
A
Phototherapy (PUVA/NB-UVB) → Methotrexate
25
Treatment of Psoriatic arthritis and Erythrodermic psoriasis
Methotrexate (>90% BSA = Erythrodermic)
26
Treatment of Pustular psoriasis
Acitretin (Vit A analogue) - Category X drug, Washout: 3 YEARS
27
Treatment of Impetigo herpetiformis (pustular psoriasis in pregnancy)
Steroids
28
5 P's of Lichen Planus
Purple, Pruritic, Polygonal, Planar, Papules
29
What are Wickham's striae?
Lacy reticular white lines on LP lesions - due to hypergranulosis
30
Nail finding in Lichen Planus
Dorsal pterygium formation (Nail tenting)
31
Treatment of Lichen Planus
Topical Steroids
32
Causative agent of Pityriasis Rosea
HHV 6-7
33
3 characteristic features of Pityriasis Rosea
1. Herald patch 2. Christmas tree pattern 3. Collarette/Cigarette paper scales
34
Management of Pityriasis Rosea
Conservative (self-limiting)
35
3 features of Pityriasis Rubra Pilaris
1. Perifollicular hyperkeratosis 2. Islands of sparing 3. Palmoplantar keratoderma
36
Causative organism of Tinea Nigra and culture media
Hortaea werneckii - SDA agar + Olive oil, 'Fried egg' appearance
37
Wood's lamp finding in Tinea Versicolor
Golden yellow fluorescence
38
Most common organism causing Tinea Versicolor
Malassezia globosa - 'Spaghetti and meatball' appearance
39
Treatment of hypopigmentation in Tinea Versicolor
Azelaic acid (blocks tyrosinase)
40
Wood's lamp specifications
UV-A 365nm with Barium silicate + NiO filter
41
Most common organism causing Impetigo
Streptococcus pyogenes > Staphylococcus aureus - Honey crusting
42
Causative organism of Bullous Impetigo
Staphylococcus aureus (Exfoliative toxin)
43
Millian's ear sign indicates which condition?
Erysipelas (involvement of ear pinna confirms diagnosis)
44
Differentiate Erysipelas vs Cellulitis
Erysipelas: Well-defined raised lesions, Epidermis + Complete dermis; Cellulitis: Ill-defined deeper lesions, Epidermis + Partial dermis
45
SSSS attacks which desmoglein? Oral mucosa involved?
Attacks DSG-1, Oral mucosa: NO
46
Reiter syndrome triad and triggers
'Can't see, Can't pee, Can't climb a tree' - Conjunctivitis, Urethritis, Arthritis. Triggers: Campylobacter/Shigella
47
Reiter syndrome skin manifestations
Keratoderma blennorrhagicum + Circinate balanitis
48
Which drug causes Fournier's gangrene?
Gliflozins (SGLT-2 inhibitors). Testes NOT involved
49
Skin condition in diabetics with thickening of skin
Scleredema diabeticorum
50
Wood's lamp finding in Erythrasma and organism
Coral red fluorescence - Corynebacterium minutissimum
51
Two types of Acanthosis Nigricans
1. Metabolic syndrome (Insulin resistance, PCOD, HAIR-AN syndrome) 2. Paraneoplastic (Adenocarcinoma)
52
Definition of Hidradenitis Suppurativa
Superadded infection following obstruction of apocrine sweat glands in axilla/groin
53
Darier's disease defect and nail finding
Ca2+ ATPase channel abnormality. V-shaped nail split. H/P: Crop grains/Corps ronds
54
Hailey-Hailey disease histopathology and nail finding
Dilapidated brick wall appearance. Longitudinal nail lines
55
DOC for Tinea capitis
Griseofulvin
56
Causes of Scarring alopecia - mnemonic TLD
T: Tinea capitis, L: Lichen planus, D: DLE (Discoid lupus)
57
Difference between Telogen vs Anagen effluvium
Telogen: Stress/pregnancy (3 months post); Anagen: Chemotherapy
58
Alopecia Areata associations
Type 1 DM, Hashimoto's thyroiditis (Autoimmune)
59
Alopecia Areata signs
Exclamation mark sign, 'Going white overnight', Regular nail pitting
60
Footprints in snow appearance
Pseudopelade of Brocq
61
Treatment of Androgenic alopecia
Minoxidil + Finasteride
62
Define Alopecia totalis vs universalis vs Ophiasis
Totalis: Total scalp loss; Universalis: All body hair loss; Ophiasis: Along scalp margin, Sisaipho pattern (spares sides/back)
63
Definition and organism of Kerion
Tender boggy swelling with lymphadenopathy - Trichophyton mentagrophyte (MCC)
64
Which dermatophyte affects Hair, Skin, and Nails?
TRICHOPHYTON (Pencil-shaped macroconidia)
65
Which dermatophyte affects Skin and Hair?
MICROSPORUM (Spindle-shaped macroconidia) - causes Gray patch, Ectothrix
66
Which dermatophyte affects Skin and Nails?
EPIDERMOPHYTON (Club/Clavate-shaped macroconidia)
67
Endothrix vs Ectothrix in fungal hair infection
Endothrix: Black dot appearance; Ectothrix: Gray patch
68
Favus is caused by which organism?
Trichophyton schoenleinii - Scutula (crusting)
69
Most common type of Onychomycosis and DOC
DLSO (Distal Lateral Subungual Onychomycosis). DOC: Terbinafine
70
DOC for Tinea corporis
Azoles
71
What is Tinea incognito?
Fungal infection with non-classical morphology due to topical steroid use
72
Chloasma/Melasma cause and Wood's lamp finding
Mask of pregnancy - Pregnancy/OCP (↑Estrogen). Wood's lamp: Positive (epidermal)
73
Differentiate epidermal vs dermal pigmentation
Epidermal: Brown, Wood's lamp +ve; Dermal: Bluish/Slate gray, Wood's lamp -ve (Tyndall phenomenon)
74
Nevus of Ota vs Nevus of Ito distribution
Ota: Periocular (V1, V2 dermatome); Ito: Shoulder/supraclavicular
75
Chikungunya skin sign
CHIK sign (hyperpigmented macules on face)
76
Waardenburg syndrome features
White forelock + Heterochromia iridis
77
Most common type of Vitiligo
Vitiligo vulgaris
78
Poor prognostic factors in Vitiligo (4 factors)
1. Long standing 2. Bony prominences 3. Leukotrichia (white hair) 4. Lip-tip
79
Treatment of Vitiligo
Topical Steroids/Tacrolimus
80
Nevus anemicus is what type of disorder?
Vascular disorder - Localized vasoconstriction
81
Hypomelanosis of Ito follows which lines?
Blaschko lines
82
Acne with papules - Treatment
Topical Retinoids + Topical Antibiotics (Clindamycin)
83
Acne with pustules - Treatment
Topical Retinoids + Topical Antibiotics + Oral Antibiotics + Benzoyl peroxide
84
Nodulo-cystic acne - Treatment
Isotretinoin (Teratogenic - Washout: 3 MONTHS, Hepatotoxic, Alters lipid profile)
85
Most common side effect of Isotretinoin
Cheilitis
86
Incontinentia pigmenti inheritance and gene
X-linked dominant (lethal in males) - NEMO gene
87
4 phases of Incontinentia pigmenti
1. Vesicular 2. Verrucous 3. Hyperpigmentation (Blaschko lines) 4. Hypopigmentation
88
Ridley-Jopling classification of Leprosy (5 types)
TT → BT → BB → BL → LL
89
Route of infection in Leprosy
Inhalation
90
Most common cranial nerve involved in Leprosy
7th cranial nerve (Facial)
91
Most common nerve for biopsy in Leprosy
Radial cutaneous nerve > Sural nerve
92
Earliest sensation lost in Leprosy
Cold temperature
93
Fite-Faraco stain is used for
Mycobacterium leprae
94
Prophylaxis for Leprosy contacts
Rifampicin single dose (>2 years, >20hrs/week contact for >3 months)
95
Impact indicator for NLEP
Prevalence <1/10,000 + Newly diagnosed cases with Grade 2 disability
96
PB Leprosy - Skin lesions and nerve involvement
Skin lesions: 0-5, Nerves: 0-1, SSS: Negative
97
MB Leprosy - Skin lesions and nerve involvement
Skin lesions: >5, Nerves: >1, SSS: Positive
98
MDT duration for PB vs MB
PB: 6 months, MB: 12 months
99
PB adult MDT regimen - Day 1
2 capsules Rifampicin 300mg + 1 tablet Dapsone 100mg
100
PB adult MDT regimen - Days 2-28
1 tablet Dapsone 100mg daily
101
MB adult MDT regimen - Day 1
2 capsules Rifampicin 300mg + 3 capsules Clofazimine 100mg + 1 tablet Dapsone 100mg
102
MB adult MDT regimen - Days 2-28
1 capsule Clofazimine 50mg + 1 tablet Dapsone 100mg daily
103
Type 1 Lepra reaction - When and in which types?
Within 12 months of Rx. Seen in BT, BB, BL
104
Type 2 Lepra reaction (ENL) - When and in which type?
Anytime during/after treatment. Seen in LL
105
Type 1 Lepra reaction clinical features
Pre-existing lesions become red & tender
106
Type 2 Lepra reaction (ENL) clinical features
New nodular lesions + Systemic involvement (Fever, Arthralgia, Orchitis)
107
Treatment of Type 1 Lepra reaction
Do NOT stop MDT. 1st line: NSAIDs, DOC: Steroids
108
Treatment of Type 2 Lepra reaction
Continue steroids & add Clofazimine/Thalidomide
109
Kit 1 (Grey) - Indications
Urethral discharge, Cervical discharge, Painful scrotal swelling
110
Kit 1 composition
Tab Azithromycin 1g OD stat + Tab Cefixime 400mg OD stat
111
Kit 2 (Green) - Indication
Vaginal discharge syndrome
112
Kit 2 composition
Tab Secnidazole 2g OD stat + Cap Fluconazole 150mg OD stat
113
Kit 3 (White) - Indication
Genital ulcer - Non-herpetic
114
Kit 3 composition
Inj Benzathine penicillin 2.4 MU + Tab Azithromycin 1g single dose
115
Kit 4 (Blue) - When to use?
Genital ulcer non-herpetic if allergic to penicillin
116
Kit 4 composition
Doxycycline 100mg BID x 15 days + Azithromycin 1g single dose
117
Kit 5 (Red) - Indication
Genital ulcer - Herpetic
118
Kit 5 composition
Tab Acyclovir 400mg TDS x 7 days
119
Kit 6 (Yellow) - Indication
Lower abdominal pain syndrome
120
Kit 6 composition
Cefixime 400mg stat + Metronidazole 400mg BID x 14 days + Doxycycline 100mg BID x 14 days
121
Kit 7 (Black) - Indication
Inguinal bubo syndrome
122
Kit 7 composition
Doxycycline 100mg BID x 21 days + Azithromycin 1g single dose
123
Treatment of Primary, Secondary, Early latent Syphilis
Benzathine Penicillin 2.4 MU single dose
124
Treatment of Late latent Syphilis
Benzathine Penicillin 2.4 MU x 3 doses (weekly)
125
Treatment of Neurosyphilis
Aqueous Penicillin
126
Painful genital ulcer with groove sign
Lymphogranuloma venereum (LGV) - Chlamydia trachomatis (L2 serovar). IP: 3-30 days
127
Painful genital ulcer - HSV features
Erythematous vesicles/erosions. IP: 2-7 days
128
Painful genital ulcer - Chancroid organism and appearance
Haemophilus ducreyi. 'School of fish' appearance. Suppurative LN (Bubo). IP: 2-5 days
129
Painless hard indurated ulcer with painless LN
Primary Syphilis. Bilateral shotty LN. IP: 9-90 days
130
Painless beefy red ulcer with pseudobubo
Granuloma inguinale/Donovanosis. Bipolar 'Safety pin' appearance. IP: 8-80 days
131
Bacterial Vaginosis - AMSEL criteria (4 criteria)
1. pH >4.5 2. Clue cells 3. Positive whiff test (KOH) 4. Thin off-white discharge with fishy odor
132
Trichomonas vaginalis finding
Strawberry cervix. pH >4.5. Motile trichomonads. 'Sheesh kebab' sign. Culture: Diamond medium
133
Candida vaginalis features
Thick 'cottage cheese' discharge. Normal pH (3.8-4.5). Pseudohyphae
134
Actinomyces association
IUD. 'Cotton wool' appearance
135
Nikolsky sign positive in which conditions?
Pemphigus vulgaris, SSSS
136
Pemphigus vulgaris - Split level and antibody
Suprabasal split (DSG-3). 'Row of tombstones' appearance. Oral ulcers present
137
Pemphigus foliaceus - Split level
Subcorneal split (DSG-1). Erosions. NO oral ulcers
138
Bullous pemphigoid - Clinical and immunofluorescence
Tense bullae + Itching (↑eosinophils). Linear IgG/C3 at dermo-epidermal junction
139
Direct IF finding in Pemphigus vulgaris
'Fish net' appearance
140
Direct IF finding in Bullous pemphigoid
'Linear' IgG/C3 deposition
141
Chronic bullous disease of childhood - IF and treatment
Linear IgA disease. 'String of pearls' appearance. Rx: Dapsone
142
Dermatitis herpetiformis association and treatment
Celiac disease. IgA deposition at papillary tips. Rx: Dapsone
143
Salt split IF - Roof vs Floor
Roof: Bullous pemphigoid; Floor: Epidermolysis Bullosa
144
Most common type of Epidermolysis Bullosa
EB Simplex (Keratin 5/14 defect)
145
Most common cause of Fixed Drug Eruption
NSAIDs - Heals with hyperpigmentation
146
SJS vs TEN - BSA involvement
SJS: <10% BSA; TEN: >30% BSA
147
3 most common drugs causing SJS-TEN
1. Carbamazepine 2. Lamotrigine 3. Allopurinol
148
SCORTEN score
Score of Toxic Epidermal Necrolysis (mortality prediction)
149
Livedo reticularis is caused by
Amantadine
150
Flagellate dermatitis is caused by
Bleomycin
151
Blue man syndrome is caused by
Amiodarone
152
Red man syndrome is caused by
Vancomycin (Histamine release)
153
Grey baby syndrome is caused by
Chloramphenicol
154
Hand-foot syndrome is caused by
5-FU/Capecitabine
155
Purple toe syndrome is caused by
Warfarin
156
ART drug causing skin/nail pigmentation
Zidovudine
157
ART drug causing palmar hyperpigmentation
Emtricitabine
158
Drug causing Pseudolymphoma/Purple glove syndrome
Phenytoin
159
Drug causing Ichthyosis
Clofazimine
160
Basal Cell Carcinoma clinical features
'Rodent ulcer' - Rolled out pearly edges with telangiectasia
161
Basal Cell Carcinoma histopathology
Palisading of basal cells
162
Basal Cell Carcinoma molecular defect and treatment
Sonic Hedgehog mutation. Rx: Vismodegib, Moh's micrographic surgery
163
ABCDE rule for Melanoma
A: Asymmetry, B: Borders irregular, C: Color variation, D: Diameter >6mm, E: Evolving
164
Most important prognostic factor in Melanoma
Breslow's depth
165
Seborrheic keratosis appearance
'Stuck on' appearance
166
Sign of Leser-Trelat
Sudden appearance of multiple seborrheic keratoses - Paraneoplastic syndrome (Adenocarcinoma)
167
Kaposi sarcoma causative agent and associations
HHV-8. Seen in HIV/AIDS. Also causes: Castleman's disease, Primary effusion lymphoma
168
Lollipop sign seen in
Basal Cell Carcinoma histopathology
169
Irritant contact dermatitis vs Allergic contact dermatitis
Irritant: Detergents, non-immunologic; Allergic: Type 4 HS, Patch test positive at 48-96 hrs
170
Most common allergen in Allergic CD
Nickel (artificial jewelry)
171
Allergen in cement causing contact dermatitis
Potassium dichromate
172
Allergen in hair dyes
PPD (Para-phenylenediamine)
173
Allergen in bindi adhesives
PTBP
174
Allergen in rubber products
MBEH (Mono-benzyl ether of hydroquinone)
175
Allergen in airborne contact dermatitis
Parthenium (Congress grass) - Sesquiterpene lactone
176
Atopic dermatitis infant distribution
Face (cheeks), scalp, ears, Extensor extremities
177
Atopic dermatitis childhood distribution
Face, Flexural extremities
178
Atopic dermatitis adult distribution
Localized flexural extremities, Hands, dorsum feet
179
Atopic dermatitis ocular finding
Shield-like cataract
180
Atopic dermatitis characteristic
Itch-scratch-itch cycle. Type 1 hypersensitivity
181
Histopathology of acute contact dermatitis
Spongiosis (intercellular edema in epidermis)
182
Dermographism definition
Exaggerated wheal response to stroking skin
183
Cholinergic urticaria trigger
Sweating
184
Darier's sign and condition
Urticaria on rubbing skin lesions - Cutaneous mastocytosis (CD117/CKIT positive)
185
Hereditary Angioedema defect
C1-esterase inhibitor deficiency. ↑Bradykinin, ↓C4. No wheals, not histamine-mediated
186
DOC for Hereditary Angioedema
Danazol/Lanadelumab
187
Neurofibromatosis-1 hallmark cutaneous findings
≥6 Cafe au lait macules (>5mm prepubertal, >15mm postpubertal) + Dermal neurofibromas + Lisch nodules (iris)
188
Tuberous Sclerosis pathognomonic cutaneous sign
Ash-leaf macules (hypopigmented). Also: Shagreen patches, Subungual fibromas
189
Dermatomyositis pathognomonic signs
Heliotrope rash (eyelids) + Gottron's papules (knuckles) + Shawl sign
190
Most common type of cutaneous TB
Lupus vulgaris - 'Apple jelly' nodules on diascopy
191
Scabies - Number of mites and DOC
~10 mites. DOC: 5% Permethrin
192
Most common site of TB in children
Scrofuloderma (lymph node TB)
193
Central scarring vs Central clearing vs Central crusting
Central scarring: TB; Central clearing: Tinea; Central crusting: Kala-azar
194
Discoid Lupus Erythematosus typical site
Photo-exposed areas with follicular plugging
195
Malar rash characteristic in SLE
Butterfly rash SPARING nasolabial folds
196
Seborrheic dermatitis distribution
Scalp, eyebrows, nasolabial folds, chest
197
Rosacea triggers and features
Triggers: Heat, alcohol, spicy food. Features: Telangiectasias, flushing
198
Ichthyosis vulgaris features
'Fish scale' appearance. Most common site: Lower limbs. Spares flexures
199
X-linked ichthyosis characteristic
Scales on trunk (including flexures)
200
Lamellar ichthyosis neonate presentation
'Collodion baby'
201
Netherton syndrome triad and gene
Bamboo hair (trichorrhexis invaginata) + Ichthyosis linearis circumflexa + Atopic dermatitis. Gene: SPINK5
202
Trichothiodystrophy characteristic
'Tiger tail' hair under polarized microscopy. PIBIDS syndrome
203
Morphea definition
Localized scleroderma - 'Box sign' (area of sclerosis with surrounding hyperpigmentation)
204
Dermatitis artefacta characteristic
Self-inflicted lesions. Accessible areas by non-dominant hand
205
Hypopigmented facial lesions - Differential (3)
1. Pityriasis alba (itchy, scales, atopy) 2. Indeterminate leprosy (sensory loss) 3. Vitiligo
206
Lichen sclerosus symptom
Dyspareunia (painful intercourse) - causes 'figure of 8' distribution in anogenital area
207
Guttate psoriasis characteristics
Linked to underlying infection (Streptococcal). Only type treated with antibiotics (Macrolides)
208
Pustular psoriasis trigger
Withdrawal of steroids. Increased Prostaglandins
209
Blaschko lines vs Langer lines
Blaschko: Embryological, V-shaped on back, midline separation; Langer: Tension lines for incisions
210
Lichen nitidus histopathology
'Claw catching ball' appearance
NEET-PG
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