Top Dermatology Multiple Choice Questions and Answers

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125 TOP DERMATOLOGY MULTIPLE CHOICE QUESTIONS

AND ANSWERS

1.    Which of the following would be prescribed for acne?


         A.    Actiq
     B.    Actonel
     C.    Accu-Check
     D.    Accutane
Ans: D  
2.    An absence of pigment in the skin is called
         A.    acanthosis nigricans
     B.    albinism
     C.    melanism
     D.    xanthoderma
Ans: B
3.    A burn which involves 2 layers of the skin and estroys the nerves and blood vessels, but
does not go down to muscle or bone is a
         A.    first-degree burn
     B.    second-degree burn
     C.    third-degree burn
     D.    full-thickness burn
Ans: B
4.    Death of tissue associated with loss of blood supply to the affected area is called
         A.    cellulitis
     B.    eczema
     C.    gangrene
     D.    psoriasis
Ans: C
5.    An acute eruption of intensely itchy papules or wheals is called
         A.    acne vulgaris
     B.    pityriasis rosea
     C.    psoriasis
     D.    urticaria (hives.
Ans: D
6.    Moles with the potential to develop into malignant melanoma are
         A.    intradermal nevi
     B.    dysplastic nevi
     C.    giant nevi
     D.    verrucae
Ans: B
7.    The type of cyst contains yellowish sebum and is commonly found on the scalp, vulva,
and scrotum.
         A.    papule
     B.    sebaceous cyst
     C.    ulcer
     D.    vesicle
Ans: B
8.    Excessive hair on the face or body, especially in women, is called:
         A.    albinism
     B.    atrichia
     C.    alopecia
     D.    hirsutism
Ans: D
9.    The half-moon shaped, white area located at the base of a fingernail is called the
         A.    basal layer
     B.    cuticle
     C.    lunula
     D.    stratum
Ans: C
10.    An epidermal growth caused by a virus (wart.) is called a
         A.    impetigo
     B.    melanoma
     C.    nevus
     D.    verruca
Ans: D

11.    Yellowing of the skin is indicative of

       A.    hyperbillirubinemia
     B.    hyperuricemia
     C.    hyperkalemia
     D.    hyporeninemia
Ans: A
12.    Which of the following is a combining form meaning skin?

       A.    adip/o
     B.    cutane/o
     C.    pachy/o
     D.    xanth/o
Ans: B

13.    A chronic dermatitis of unknown etiology in patients with a history of allergy is called

       A.    actinic dermatitis


     B.    atopic dermatitis
     C.    stasis dermatitis
     D.    seborrheic dermatitis
Ans: B

14.    The outermost layer of skin is the

       A.    dermis
     B.    endodermis
     C.    epidermis
     D.    hypodermis
Ans: C

15.    Of the three layers of the skin, which is the thick, fat-containing layer?

       A.    dermis
     B.    epidermis
     C.    epithelium
     D.    subcutaneous tissue
Ans: D

16.    The brown-black pigment of the skin that is transferred to other epidermal cells and
gives the skin its color is called

       A.    albumin
     B.    collagen
     C.    keratin
     D.    melanin
Ans: D
17.    Which of the following is transcribed correctly?

       A.    The patient was given metronidazole for rosacea and Lamisil for onychomycosis.
     B.    The patient was given metronidazole for roseola and Lamisil for onychomycosis.
     C.    The patient was given metronidazole for roseola and Lamisil for onychomycosis.
     D.    The patient was given metroprolol for rosacea and Lamisil for onychomycosis.
Ans: A

18.    Apocrine glands produce

       A.    mucus
     B.    sebum
     C.    sweat
     D.    keratin
Ans: C

19.    Which of the following infections is also known as ringworm?

       A.    folliculitis
     B.    herpes simplex
     C.    impetigo
     D.    tinea corporis
Ans: D

20.    Another term for itching is

       A.    dermatitis
     B.    keratosis
     C.    petechiae
     D.    pruritus
Ans: D

21.    The skin, hair, nails, and glands all make up this system of the body.

       A.    integumentary system


     B.    lymphatic system
     C.    musculoskeletal system
     D.    nervous system
Ans: A
22.    Clotrimazole and nystatin are both

       A.    topical antifungals


     B.    anti-itch creams
     C.    topical antibiotics
     D.    used to treat eczema
Ans: A

23.    Which skin neoplasm is associated with an increase in the growth of cells in the
keratin layer of the epidermis caused by pressure or friction?

       A.    callus
     B.    keloid
     C.    keratosis
     D.    leukoplakia
Ans: A

24.    In this condition, there is a scaly dermatitis affecting parts of the skin that are
supplied by oil glands.

       A.    chronic dermatitis


     B.    contact dermatitis
     C.    eczema
     D.    seborrheic dermatitis
Ans: D

25.    Which of the following is a fungal infection?

       A.    lichen planus


     B.    keratosis
     C.    suborrhea
     D.    tinea capitis
Ans: D

26.    A groove or a crack-like sore is called a (an.

       A.    fissure
     B.    nodule
     C.    polyp
     D.    ulcer
Ans: A
27.    Which of the following is transcribed correctly?

       A.    This 58-year-old woman had a biopsy proven melanoma.

Clarks level 1, on the left cheek.


     B.    This 58-year-old woman had a biopsy-proven melanoma.

Clark's level 1, on the left cheek.


     C.    This 58-year-old woman had a biopsy proven melena.

Clark level 1, on the left cheek


     D.    This 58-year-old woman had a biopsy-proven melanoma.

Clark level 1, on the left cheek.

 (Correct Ans: D

28.    Follicular dilation involving the nose and portions of the cheeks, erythema, papules,
and pustules are classic signs of this dermatologic disorder.

       A.    acne cosmetica


     B.    acne pustulosa
     C.    acne rosacea
     D.    acne vulgaris
Ans: C

29.    A skin disorder most often caused by the herpes virus and consisting of red lesions
that look like targets is

       A.    candidiasis
     B.    erythema multiforme
     C.    hirsutism
     D.    keratosis pilaris
Ans: B

30.    The vascular layer of skin is the

       A.    dermis
     B.    epidermis
     C.    stratum corneum unguis
     D.    hypodermis
Ans: A
31.    When scraping for demodex, it may be helpful to pinch the skin while you scrape.

       A.    True
     B.    False
Ans: A

32.    Impetigo is confined to the glabrous areas of a dog's body

       A.    True
     B.    False
Ans: A

33.    What is the growth phase of a hair follicle?

       A.    Anagen
     B.    Catagen
     C.    Growagen
     D.    Telogen
Ans: A

34.    What is one way to distinguise ARF from FAD?

       A.    Excoriations
     B.    Papules
     C.    GI Signs
     D.    Scratching of muzzle
Ans: C

35.    Atopy is curable

       A.    True
     B.    False
Ans: B

36.    Animals with fur have what type of follicles?

       A.    Simple
     B.    Intermediate
     C.    Compound
     D.    Fuzzy
Ans: C
37.    When is a dog "cured" of demodex?

       A.    Disease free for 1 year


     B.    After 2 negative scrapes
     C.    Never
     D.    After 1 negative scrape
Ans: A

38.    Dermatophilosis is zoonotic

       A.    True
     B.    False
Ans: A

39.    Accral lick dermatitis can be a behavioral problem

       A.    True
     B.    False
Ans: A

40.    Superficial pyoderma is a secondary disease process.

       A.    True
     B.    False
Ans: A

41.    Eosinophillic Granuloma Complex is a disease in and of itself.

       A.    True
     B.    False
Ans: B

42.    FAD is what type of reaction?

       A.    Type I (Missed.


     B.    Type II
     C.    Type III
     D.    Type IV (Missed.
Ans: A,D
43.    All in contact dogs should be treated in a scabies case.

       A.    True
     B.    False
Ans: A

44.    Canine FAD lesions are usually found on the rump, feline are on the head.

       A.    True
     B.    False
Ans: A

45.    Failure to treat localized demedocosis will cause the dog to develop generalized
demedocsis later on.

       A.    True
     B.    False
Ans: B

46.    What is the resting phase of a hair follicle?

       A.    Anagen
     B.    Catagen
     C.    Relaxagen
     D.    Telogen
Ans: D

47.    Notoedres can only infect cats

       A.    True
     B.    False
Ans: B

48.    Wetting an area down with alchohol before plucking hairs for culture will decrease
inaccurate tests.

       A.    True
     B.    False
Ans: A
49.    What is the signalment for pemphigus foliaceus?

       A.    Any age


     B.    Elderly animals
     C.    Very young puppies
     D.    Young to middle aged adults
Ans: D

50.    Otitis externa is very common in dogs with scabies.

       A.    True
     B.    False
Ans: B

51.    Juvenile Cellulitis can appear in days

       A.    True
     B.    False
Ans: A

52.    Age of onsent for puppy pyoderma

       A.    2-9 Months


     B.    3-6 months
     C.    6 months- 1 year
     D.    8 weeks-6 months
Ans: A

53.    What is the transition phase of a hair follicle?

       A.    Telogen
     B.    Catagen
     C.    Zenagen
     D.    Anagen
Ans: B

54.    In atopy, the allergens are absorbed via the skin

       A.    True
     B.    False
Ans: A
55.    Puppies grow out of their puppy coats

       A.    True
     B.    False
Ans: B

56.    When culturing a pustule, the area must first be cleaned

       A.    True
     B.    False
Ans: A

57.    Juvenile Cellulitis in dogs usually affects what part of the body

       A.    Face
     B.    Glabrous areas
     C.    Body wide
     D.    Axilla
Ans: A

58.    What is the signalment for juvenile cellulitis

       A.    6 month
     B.    1 year
     C.    3-16 week old puppies
     D.    8-12 weeks
Ans: C

59.    Demodex mites live where?

       A.    Stratum Corneum


     B.    All skin layers
     C.    In the follicle
     D.    On the hair shaft
Ans: C

61.    Demodectic mange is pruritic

       A.    True
     B.    False
Ans: B
62.    It is necessary to clean the environment to eliminate ringworm

       A.    True
     B.    False
Ans: A

63.    Which AB is responsible for atopy?

       A.    IgA
     B.    IgE
     C.    IgG
     D.    IgW
Ans: B

64.    If not pruritic, linear granulomas should be treated how

       A.    Prednisone
     B.    Prednisolone
     C.    Scientific Neglect
     D.    Cyclosporin
Ans: C

65.    Where are scabies mites found?

       A.    Hair Follicles


     B.    Stratum Corneum
     C.    Sub-epidermal
     D.    Throughout the skin layers
Ans: B

66    Surface irritation and inflammation caused by frictional trauma of skin on skin

       A.    Skin Fold Dermatitis


     B.    Furunculosis
     C.    Alopecia
     D.    Vesicle
Ans: A

67.    Small elevation of skin containing purulent material

       A.    Papule
     B.    Pustule
     C.    Vesicle
     D.    Cyst
Ans: B
68.    An erosion exposes the dermis underneath

       A.    True
     B.    False
Ans: B

69.    An ulcer is:

       A.    Shallow Epidermal defect


     B.    Break in epidermis with exposure of dermis
     C.    Not good for coffee drinkers
     D.    A primary problem
Ans: B

70.    Alopecia is:

       A.    Full or partial hair loss


     B.    Difficult for men to deal with
     C.    Only full hair loss
     D.    Never where you want it to be
Ans: A

60.    FAD and insect hypersensitivity in horses are both similar not only in their
presentation, but also in their "cure".

       A.    True
     B.    False
Ans: A

71.    Pyotraumatic Dermatitis is also known as a "hot spot"

       A.    True
     B.    False
Ans: A

72.    Excessive scaling is:

       A.    Gross
     B.    Seborrhea
     C.    Dandruff
     D.    Epidermal Collarette
Ans: B
73.    A vesicle is a sharply circumscribed lesion containing fluid

       A.    True
     B.    False
Ans: A

74.    What is another term for intertrigo?

       A.    Furunculosis
     B.    Pyotraumatic Dermatitis
     C.    Skin Fold Dermatitis
Ans: C

75.    Circumscribed, developmental skin defect

       A.    Nevus
     B.    Macule
     C.    Papule
     D.    Pustule
Ans: A

76.    Scale is an accumulation of fragments of stratum corneum

       A.    True
     B.    False
Ans: A

77.    Inflammation secondary to rupture of a hair follicle

       A.    Furunculosis
     B.    Pustule
     C.    Vesicle
     D.    Plaque
Ans: A

78.    Remnants of a pustule, vesicle, or bulla can be

       A.    Epidermal Collarette


     B.    Scale
     C.    Plaque
     D.    Cyst
Ans: A
79.    Circumscribed lesion that is raised and consists of edema is urticaria

       A.    True
     B.    False
Ans: A

80.    What is a bulla?

       A.    Taunted by a bulla fighta


     B.    A large vesicle
     C.    Hives
     D.    A large cyst
Ans: B

81.    A comedone is a primary problem only

       A.    True
     B.    False
Ans: B

82.    Actinic means related to chemically active rays of the electromagnetic spectrum.

       A.    True
     B.    False
Ans: A

83.    Accumulation of keratin and follicular material that adheres to hair shaft

       A.    Impetigo
     B.    Scales
     C.    Follicular Cast
Ans: C

84.    Thickening of the epidermis and/or dermis

       A.    Callus
     B.    Lichenification
     C.    Scaling
     D.    Lacking in sensitive people
Ans: B
85.    Circumscribed, non-palpable area characterized by color change

       A.    Patch
     B.    Papule
     C.    Macule
Ans: C

86.    A patch is a large macule

       A.    True
     B.    False
Ans: A

87.    "Scratch" is a lay term for excoriation

       A.    True
     B.    False
Ans: A

88.    Dilated hair follicle containing cornified cells and debris

       A.    Comedone
     B.    Pustule
     C.    Furunculosis
Ans: A

89.    A cicatrix is:

       A.    benign
     B.    a lesion
     C.    a scar
Ans: C

90.    A cyst is a closed sack of pouch under the skin.

       A.    true
     B.    false
Ans: A

91.    Ecchymosis means:

       A.    A condition of the ear


     B.    Skin discoloration
     C.    Excessive sweating
Ans: B
92.    Eczema is an inflammatory condition of the skin.

       A.    True
     B.    False
Ans: A

93.    Erythema:

       A.    blood condition


     B.    red
     C.    lack of pigmentation
Ans: B

94.    Gangrene is necrosis (dead. tissue due to decomposition.

       A.    True
     B.    False
Ans: A

95.    Herpes is:

       A.    An S.T.D.


     B.    a cold sore or fever blister
     C.    an invasion of pyogenic bacterium
Ans: B

96.    Herpes Zoster is most commonly known as:

       A.    shingles
     B.    an enlarged fever blister
     C.    blue colored skin
Ans: A

97.    Cyanoderma means:

       A.    red skin


     B.    blue skin
     C.    yellow skin
Ans: B
98.    Impetigo is a contagious bacterial skin infection with pustules that rupture.

       A.    True
     B.    False
Ans: A

99.    Kaposi's Sarcoma is a cancer associated with:

       A.    Smokers
     B.    A.I.D.S.
     C.    Sun exposure
Ans: B

100.    A Laceration is:

       A.    a pathological change in tissue


     B.    torn skin
     C.    laser treatment for skin disease.
Ans: B

101.    Metastasis means to:

       A.    spread infection from one person to another


     B.    move or spread through the blood stream or lymph nodes
     C.    abnormal breast condition
Ans: B

102.    Benign means non-cancerous.

       A.    True
     B.    False
Ans: A

103.    A 1st degree burn is:

       A.    the most severe type of burn


     B.    superficial burn injuring the top layer of skin
     C.    the first time the patient has been burned.
Ans: B

104.    ___________ means itching caused by dry skin, parasitic infection or disease.

       A.    Scabies
     B.    Herpes Zoster
     C.    Pruritis
Ans: C
105.    Tinea ________ means ring worm, athlete's foot.

       A.    purpura
     B.    impetigo
     C.    corporis
Ans: C

106.    Scabies is a contagious skin condition caused by parasitic mites.

       A.    True
     B.    False
Ans: A

107.    Pediculosis means:

       A.    Inflammatory condition of the skin.


     B.    Infestation with lice
     C.    Irritated and peeling feet.
Ans: B

108.    Petechiae is a small _____________ spot on the skin.

       A.    hemorragic
     B.    raised
     C.    discolored
Ans: A

109.    Urticaria means:

       A.    allergic reaction of the skin


     B.    thickened skin
     C.    dead tissue
Ans: A

110.    SLE stands for_________________ and is an autoimmune disease.

       A.    squamous laceration ecchymosis


     B.    systemic lupus erythematosus
     C.    septic lymphodic edema
Ans: B
111.    Similar to a vescle but larger usually more than 5mm in diameter, consisting of clear
fluid accumulated within or below the epidermis.

       A.    Vesicle
     B.    Pustule
     C.    Bulla
     D.    Cyst
Ans: C

112.    Dried exudate on the surface of the skin.

       A.    Plaque
     B.    Crust
     C.    Scale
 Ans: B

113.    A localized area of colour or textural change in the skin

       A.    Macule
     B.    Ecchymosis
     C.    Freckle
 Ans: A

114.    Alopecia is the absence of hair?

       A.    True
     B.    False
Ans: A

115.    Atrophic skin is thin, translucent and wrinkled with easily visable blood vessels

       A.    True
     B.    False
Ans: A

116.    An acute abscess formation in adjacent hair follicles.

       A.    Carbuncle
     B.    Furuncle
     C.    Folliculitis
Ans: B
117.    A compressible papule or plaque of dermal oedema, red or white in colour.

       A.    Urticaria (Missed.


     B.    Erythema
     C.    Wheal (Missed.
     D.    Purpura
Ans: A,C

118.    A pustule is a visible collection of pus in a blister. Pustules can be seen in psoriasis

       A.    True
     B.    False
Ans: A

119.    A purulent inflammation of the skin and subcutaneous tissue

       A.    Erythema
     B.    Ecchymosis
     C.    Cellulitis
Ans: C

120.    A small solid elevation of the skin, generally defined as less than 5mm, maybe flat or
domeshaped.

       A.    Nodule
     B.    Papule
     C.    Macule
Ans: B

121.    Irritants cause more contact dermatitis than allergens do?

       A.    True
     B.    False
Ans: A

122.    Contact dermatitis, which of the following are common irritants?

       A.    Water (Missed.


     B.    temperature extremes (Missed.
     C.    Frictional abrasives (Missed.
     D.    Nickel
Ans: D

   
123.    Atopic eczema induces lichenification

       A.    True
     B.    False
Ans: A

124.    Treatments used to treat Atopic eczema

       A.    Emollients (Missed.


     B.    Antihistamines (Missed.
     C.    Hot baths
     D.    Topical steroids (Missed.
     E.    Antibiotics (Missed.
     F.    Wear wool clothing
Ans: C

125.    Types of Eczema

       A.    Discoid eczema (Missed.


     B.    Seborrhoeic Dermatitis (Missed.
     C.    Venous eczema (Missed.
     D.    Arthiritic dermatitis
     E.    Lichen simplex chronicus (Missed.
     F.    Lichen striatus (Missed.
Ans: D
DERMATOLOGY QUIZ

Question 1
What is the most common causative agent of erythema multiforme (EM)?
A Penicillin and sulphonamides
B Systemic lupus erythematosus
C HSV infection
D Malignancy
Answer C
Question 1 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 2
What is a precursor to squamous cell carcinoma (SCC)?
A Keratoacanthoma
B Actinic keratosis
C Leser-Trélat sign
D Measles
Answer B
Question 2 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 3
What skin condition is caused by poxvirus?
A Verruca
B Molluscum contagiosum
C Impetigo
D Cellulitis
Answer B
Question 3 Explanation: 
Molluscum contagiosum is an umbilicated papule. It is commonly seen in children and sexually
transmitted in adults.
Question 4
What are the histological findings of psoriasis?
A Inflammation of the dermal-epidermal junction
B Peripheral palisading of basal cells
C Acanthosis, Parakeratosis and Munro microabscesses
D Keratin pseudocysts
Answer C
Question 4 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 5
What is the infective agent implicated in acne?
A Staphylococcus aureus
B Streptococcus pyogenes
C Staphylococcus epidermidis
D Propionibacterium acnes
Answer D
Question 5 Explanation: 
Propionibacterium acnes infection produces lipases resulting in inflammation and breakdown of
sebum, leading to pustule formation.

Question 6
Answer
How does lichen planus present clinically?
A Salmon coloured plaques with silvery scale
B Pruritic, red, oozing rash with edema
C Golden coloured crusts
D Pruritic, purple, polygonal, planar papules and plaques
Answer D
Question 6 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 7
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
B Seborrheic keratosis
C Basal cell carcinoma
D Melasma
Answer B
Question 7 Explanation: 
Seborrheic keratosis is a benign squamous proliferation and is seen frequently in the elderly.
Question 8
What condition is associated with acanthosis nigricans?
A Type 2 diabetes and gastric adenocarcinoma
B Rubella
C Varicella zoster
D Basal cell carcinoma
Answer A
Question 8 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 9
Correct
What childhood infection is associated with Koplik spots?
Measles
B Rubella
C Varicella
D Fifth disease
Answer A
Question 9 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 10
How does impetigo present?
Golden honey coloured crust over an erythematous base
B Salmon coloured plaque with silvery scale
Comedones, pustules and nodules
D Flesh coloured papule with a rough surface
Answer A
Question 10 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 11
What is the best indicator of prognosis for a melanoma?
A Asymmetry
Colour
C Diameter
Invasion of the dermis
Answer D
Question 11 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 12
What is Leser-Trélat sign?
Sudden appearance of multiple seborrhoeic keratoses 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
Answer A
Question 12 Explanation: 
Note that the presentation of gastric carcinoma can include Leser-Trélat sign, Virchow node,
Sister Mary Joseph nodule and Krukenberg tumour.
Question 13
What disease is associated with dermatitis herpetiformis?
A Herpes
Coeliac disease
C Atopic dermatitis
Melanoma
Answer B
Question 13 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 14
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
B Herpes
C Varicella zoster virus
Erysipelas
Answer A
Question 14 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 15
What is the pathogenesis of vitiligo?
A Congenital lack of pigmentation
B Increase in the number of melanosomes
Autoimmune destruction of melanocytes
D Benign proliferation of melanocytes
Answer C
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
What type of melanoma is often seen in dark skinned individuals?
A Superficial spreading
Lentigo maligna melanoma
C Nodular
Acral lentiginous
Answer D
Question 16 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 17
What is the pathogenesis of pemphigus vulgaris?
IgG antibody against desmoglein
IgG antibody against hemidesmosome components
C Autoimmune deposition of IgA at tips of dermal papillae
D Enzyme defect in tyrosinase
Answer A
Question 17 Explanation: 
Desmosomes are located in the stratum spinosum between keratinocytes. Antibodies against the
desmoglein component result in painful flaccid bullae or blisters that rupture easily on both skin
and oral mucosa. It is treated with corticosteroids.
Question 18
What is the most common mole found in adults?
A Junctional nevus
B Compound nevus
Intradermal nevus
D Congenital nevus
Answer C
Question 18 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 19
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
Melanoma
D Eczema
Answer B
Question 19 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.

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