Dermatology Quiz: Connective Tissue Disorders and Treatment
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Questions and Answers

What is the most associated cancer with the sudden waxy brown papules on the trunk in a 65-year-old female?

  • Liver
  • Stomach
  • Lung (correct)
  • Pancreas

In a female patient with a brown macular rash on the cubital fossa, what is the best treatment?

  • Phototherapy
  • Topical steroid (correct)
  • Cyclosporine
  • Antibiotic

Which medication is the most appropriate for treating erythema, edema, induration of the whole face, and stiffness of both lower limbs, along with periungual erythema in a patient?

  • Steroids
  • Sildenafil
  • Colchicine (correct)
  • Pentoxyphylline

In a 10-year-old child with linear morhea, what treatment should be combined with steroids?

<p>MTX (D)</p> Signup and view all the answers

What treatment is appropriate for eruptive skin-colored papules with hardness on the face and upper back?

<p>Thalidomide (A)</p> Signup and view all the answers

What is the prophylactic treatment for photosensitivity in connective tissue disease?

<p>Hydroxychloroquine (A)</p> Signup and view all the answers

In the case of granuloma with few lymphocytes and erythematous plaque in a patient with sarcoidosis, which biologic treatment would be most appropriate?

<p>Rituximab (D)</p> Signup and view all the answers

In a patient with dermatomyositis controlled on prednisolone and methotrexate (MTX) intake, who develops myopathy after one week, what would be the next appropriate step?

<p>Decrease steroid (A)</p> Signup and view all the answers

In a patient presenting with sclerodactyly, Raynaud's phenomenon, and photosensitivity, which investigation would be most relevant for diagnosing mixed connective tissue disease?

<p>U1RNP (D)</p> Signup and view all the answers

In familial systemic lupus erythematosus (SLE), which complement deficiency is associated with the condition?

<p>5 (C)</p> Signup and view all the answers

In a patient presenting with Gottron rash on both hands and rash on the ear, what would be the most appropriate treatment?

<p>Dapsone (D)</p> Signup and view all the answers

What is the most suitable treatment for a patient with acquired digital fibrokeratoma?

<p>Surgical removal (C)</p> Signup and view all the answers

In a case of dermatomyositis controlled on prednisolone and methotrexate (MTX) intake started for one week of myopathy, what is the next step?

<p>Decrease steroid (B)</p> Signup and view all the answers

In a case of a girl with an itchy hyperpigmented patch on the trunk with histopathology showing amyloidosis, which specialist should be referred to?

<p>Endocrinologist (D)</p> Signup and view all the answers

What is the most appropriate investigation needed in a case of discoid lupus with follicular plugging?

<p>Hydroxychloroquine (B)</p> Signup and view all the answers

In a case of hypertrophic discoid lupus erythematosus (DLE) with interface dermatitis and thickening basement membrane, what would be an important investigation to consider?

<p>HIV testing (B)</p> Signup and view all the answers

A patient presents with asymptomatic maculopapular lesions on the left arm. What would be the appropriate approach to treatment?

<p>Initiate symptomatic treatment (D)</p> Signup and view all the answers

What would be the most suitable treatment for a female with genital plaque and asymptomatic lichen sclerosis?

<p>Steroid therapy (B)</p> Signup and view all the answers

A patient presents with erythematous plaque on the nose with associated pustules. What would be the appropriate treatment and diagnosis?

<p>Minocycline (D)</p> Signup and view all the answers

In a case of pseudoxanthoma elasticum, what is considered as a protective treatment?

<p>Aspirin or cessation of smoking (A)</p> Signup and view all the answers

What is the expected complication in pseudoxanthoma elasticum?

<p>Peripheral arterial disease (D)</p> Signup and view all the answers

In a patient with cutis laxa presenting with mutation, periorbital edema, and sagged cheeks, what should be considered as an appropriate investigative option?

<p>Blood glucose testing (B)</p> Signup and view all the answers

A patient presents with Reynaud's phenomenon, edematous fingers, and low C3 and C4 levels. What would be the best treatment option?

<p>Hydroxychloroquine (D)</p> Signup and view all the answers

What is the prophylactic treatment for photosensitivity in connective tissue disease?

<p>Carotene (A)</p> Signup and view all the answers

In a case of granuloma with few lymphocytes and erythematous plaque in a patient with sarcoidosis, which biologic treatment would be most appropriate?

<p>Infliximab (D)</p> Signup and view all the answers

In a patient with dermatomyositis controlled on prednisolone and methotrexate (MTX) intake started for one week of myopathy, what is the next appropriate step?

<p>Increase steroid (C)</p> Signup and view all the answers

In a patient presenting with sclerodactyly, Raynaud's phenomenon, and photosensitivity, which investigation would be most relevant for diagnosing mixed connective tissue disease?

<p>U1RNP (A)</p> Signup and view all the answers

In familial systemic lupus erythematosus (SLE), which complement deficiency is associated with the condition?

<p>5 (C)</p> Signup and view all the answers

In a case of small ulcer on digit, photosensitivity, fibrosis, pigmentation, which investigation would be most appropriate?

<p>Double strand DNA (C)</p> Signup and view all the answers

In a picture of calcinosis cutis in the thigh in a renal patient, which investigation would be most appropriate?

<p>X-ray (B)</p> Signup and view all the answers

In a patient with photosensitivity, which investigation would be most appropriate?

<p>ANA (D)</p> Signup and view all the answers

What is the most associated cancer with the sudden waxy brown papules on the trunk in a 65-year-old female?

<p>Breast cancer (C)</p> Signup and view all the answers

In a patient presenting with Gottron rash on both hands and rash on the ear, what would be the most appropriate treatment?

<p>Dapsone (D)</p> Signup and view all the answers

In a case of JXG association (Juvenile xantho-granuloma), what investigation would confirm the diagnosis?

<p>CD68 staining (B)</p> Signup and view all the answers

What is the most appropriate treatment for a patient with lichen sclerosus et atrophicus?

<p>Surgical removal (B)</p> Signup and view all the answers

In a patient with amyloidosis indicated by histopathology, which specialist should they be referred to?

<p>Nephrologist (A)</p> Signup and view all the answers

In a case of lichen sclerosus et atrophicus, what is the next step of management?

<p>Topical steroid (clobetasol) (B)</p> Signup and view all the answers

What is the most appropriate treatment for a patient with discoid lupus and persistent scarring for 3 years?

<p>Camouflage (C)</p> Signup and view all the answers

In a patient with asymptomatic maculopapular lesions on the left arm, what would be the appropriate approach to treatment?

<p>Symptomatic management (B)</p> Signup and view all the answers

What investigation would be most relevant for diagnosing mixed connective tissue disease in a patient presenting with sclerodactyly, Raynaud's phenomenon, and photosensitivity?

<p>Anti-RNP (D)</p> Signup and view all the answers

What is the best treatment option for a child with Encopé de Sabre?

<p>Subcutaneous MTX (B)</p> Signup and view all the answers

What is the most associated cancer with sudden waxy brown papules on the trunk in a 65-year-old female?

<p>Liver (A)</p> Signup and view all the answers

What is the best treatment for a female patient with brown macular rash on the cubital fossa?

<p>Topical steroid (C)</p> Signup and view all the answers

Which medication is the most appropriate for treating erythema, edema, induration of the whole face, and stiffness of both lower limbs, along with periungual erythema in a patient?

<p>Steroids (A)</p> Signup and view all the answers

What treatment will you combine with steroids for linear morphea in a 10-year-old child?

<p>MTX (A)</p> Signup and view all the answers

What is considered as a protective treatment in a case of pseudoxanthoma elasticum?

<p>NBUVB (D)</p> Signup and view all the answers

What investigation would be most relevant for diagnosing mixed connective tissue disease in a patient presenting with sclerodactyly, Raynaud's phenomenon, and photosensitivity?

<p>ANA (B)</p> Signup and view all the answers

What would be an important investigation to consider in a case of hypertrophic discoid lupus erythematosus (DLE) with interface dermatitis and thickening basement membrane?

<p>Skin biopsy then DIF then ANA (A)</p> Signup and view all the answers

What is the most common site for that disease?

<p>Face (B)</p> Signup and view all the answers

What is the most associated cancer with sudden waxy brown papules on the trunk in a 65-year-old female?

<p>Stomach (D)</p> Signup and view all the answers

In a female patient with brown macular rash on the cubital fossa, what is the best treatment?

<p>Topical steroid (B)</p> Signup and view all the answers

What is the best treatment for eruptive skin-colored papules with hardness on the face and upper back?

<p>Biologic Rituximab (C)</p> Signup and view all the answers

In a patient with atrophic lesions and telangiectasia on the surface, which investigation would be most appropriate?

<p>Skin biopsy then DIF then ANA (A)</p> Signup and view all the answers

What is the most common site for that disease?

<p>Trunk (B)</p> Signup and view all the answers

Which manifestation is not associated with subacute LE?

<p>Scarring (D)</p> Signup and view all the answers

What is the prophylactic treatment for photosensitivity in connective tissue disease?

<p>Carotene (A)</p> Signup and view all the answers

In a case of granuloma with few lymphocytes and erythematous plaque in a patient with sarcoidosis, which biologic treatment would be most appropriate?

<p>Infliximab (B)</p> Signup and view all the answers

In familial systemic lupus erythematosus (SLE), which complement deficiency is associated with the condition?

<p>5 (C)</p> Signup and view all the answers

What investigation would be most relevant for diagnosing mixed connective tissue disease in a patient presenting with sclerodactyly, Raynaud's phenomenon, and photosensitivity?

<p>U1RNP (B)</p> Signup and view all the answers

What is the type of light chain in systemic amyloidosis?

<p>Lambda (C)</p> Signup and view all the answers

In a case of small ulcer on digit, photosensitivity, fibrosis, pigmentation, which investigation would be most appropriate?

<p>ANA (C)</p> Signup and view all the answers

What specialist should be referred to for a girl with an itchy hyperpigmented patch on the trunk and histopathology showing amyloidosis?

<p>Endocrinologist (B)</p> Signup and view all the answers

In a patient with discoid lupus exhibiting persistent scarring for 3 years, what would be the most appropriate treatment?

<p>No treatment (A)</p> Signup and view all the answers

In a patient with asymptomatic maculopapular lesions on the left arm, what would be the appropriate approach to treatment?

<p>Symptomatic treatment (A)</p> Signup and view all the answers

What is the most suitable treatment for a female with genital plaque and asymptomatic lichen sclerosis?

<p>Surgical removal (C)</p> Signup and view all the answers

In a case of lichen sclerosus et atrophicus, what would be the next step of management?

<p>Add acitretin (A)</p> Signup and view all the answers

Flashcards

What cancer is associated with waxy brown papules on the trunk?

Lung cancer is the most common malignancy associated with the sudden appearance of waxy brown papules on the trunk in a 65-year-old female.

Treatment for brown macular rash on the cubital fossa

Topical steroids are the preferred treatment for brown macular rash on the cubital fossa in a female patient.

Medication for erythema, edema, and stiffness

Colchicine is the most suitable medication for treating erythema, edema, induration of the whole face, stiffness of both lower limbs, and periungual erythema. These symptoms are suggestive of a connective tissue disease like scleroderma or lupus.

Treatment for linear morphea in a child

MTX (methotrexate) is the appropriate treatment to be combined with steroids for linear morphea in a 10-year-old child. This is a type of scleroderma that primarily affects the skin.

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Treatment for eruptive papules on the face and back

Thalidomide is an appropriate treatment option for eruptive skin-colored papules with hardness on the face and upper back.

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Prophylactic treatment for photosensitivity

Hydroxychloroquine, a medication used for malaria, is also the prophylactic treatment for photosensitivity in various connective tissue diseases, particularly lupus.

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Biologic treatment for sarcoidosis

Rituximab is a biologic treatment that targets B-cells, making it appropriate for granuloma with few lymphocytes and an erythematous plaque in a patient with sarcoidosis. Sarcoidosis is a rare inflammatory disease that affects various organs.

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Next step for myopathy in a dermatomyositis patient

If a patient with dermatomyositis, who is already taking prednisolone and methotrexate, develops myopathy after one week, reducing the steroid dosage is the next appropriate step.

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Investigation for mixed connective tissue disease

Testing for U1RNP antibodies is the most relevant investigation for diagnosing mixed connective tissue disease in a patient presenting with sclerodactyly, Raynaud's phenomenon, and photosensitivity.

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Complement deficiency in familial SLE

Familial systemic lupus erythematosus (SLE) is associated with a deficiency in complement component C5. Complement deficiency is a common feature of lupus, affecting the body's immune system.

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Treatment for Gottron's rash and rash on the ear

Dapsone is the most appropriate treatment for a patient presenting with Gottron's rash on both hands and rash on the ear. These are characteristic symptoms of dermatomyositis.

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Treatment for acquired digital fibrokeratoma

Surgical removal is the most suitable treatment for acquired digital fibrokeratoma, a benign tumor growth on the fingers. It's a rare condition that commonly leads to finger deformities.

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Next step for myopathy on steroid therapy

Decreasing the steroid dosage is the next appropriate step if a patient on prednisolone and methotrexate develops myopathy after a week. This is likely due to a potential side effect of the steroids.

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Specialist for amyloidosis

A patient with an itchy, hyperpigmented patch on the trunk and histopathology showing amyloidosis should be referred to an endocrinologist. Amyloidosis is a rare disease involving the buildup of amyloid proteins in tissues.

Signup and view all the flashcards

Investigation for discoid lupus with follicular plugging

Hydroxychloroquine is the most appropriate investigation needed in a case of discoid lupus with follicular plugging. Follicular plugging is a common feature and is usually asymptomatic.

Signup and view all the flashcards

Investigation for hypertrophic discoid lupus erythematosus

HIV testing is an important investigation to consider in a case of hypertrophic discoid lupus erythematosus (DLE) with interface dermatitis and thickening basement membrane. DLE is a chronic skin condition that primarily affects the face and scalp.

Signup and view all the flashcards

Treatment for asymptomatic maculopapular lesions

Symptomatic treatment is the appropriate approach to manage asymptomatic maculopapular lesions on the left arm. This is a common finding that might not require specific treatment.

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Treatment for lichen sclerosus

Steroid therapy, specifically topical clobetasol, is the most suitable treatment for a female patient with a genital plaque and asymptomatic lichen sclerosus. Lichen sclerosus is a chronic inflammatory skin condition that primarily affects the genital and perianal areas.

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Treatment for erythematous plaque on the nose with pustules

Minocycline is the appropriate treatment for a patient with an erythematous plaque on the nose with associated pustules. This is a very common skin condition.

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Protective treatment for pseudoxanthoma elasticum

Aspirin or cessation of smoking are considered protective treatments in a case of pseudoxanthoma elasticum. This is a genetic connective tissue disorder that primarily affects the skin, eyes, and blood vessels.

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Expected complication of pseudoxanthoma elasticum

Peripheral arterial disease, a condition affecting blood flow to the limbs, is a common expected complication of pseudoxanthoma elasticum.

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Investigation for cutis laxa

Blood glucose testing is an appropriate investigative option for a patient with cutis laxa presenting with mutation, periorbital edema, and sagged cheeks. Cutis laxa is a rare genetic disorder that affects the skin, resulting in loose and wrinkled skin.

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Treatment for Raynaud's phenomenon, edematous fingers, and low C3/C4

Hydroxychloroquine is the best treatment option for a patient presenting with Raynaud's phenomenon, edematous fingers, and low C3 and C4 levels (complement). These findings point towards a possible autoimmune disease like lupus.

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Prophylactic treatment for photosensitivity

Carotene, also known as Vitamin A, is the prophylactic treatment for photosensitivity in connective tissue diseases.

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Biologic treatment for sarcoidosis

Infliximab is a biologic treatment that targets TNF-alpha, making it an appropriate option for a patient with sarcoidosis and granuloma with few lymphocytes and an erythematous plaque.

Signup and view all the flashcards

Next step for myopathy on steroid therapy

Increasing the steroid dosage is the next appropriate step if a patient on prednisolone and methotrexate develops myopathy after a week. This is likely due to the insufficient steroid dose.

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Investigation for mixed connective tissue disease

Testing for U1RNP antibodies is the most relevant investigation for diagnosing mixed connective tissue disease in a patient presenting with sclerodactyly, Raynaud's phenomenon, and photosensitivity.

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Complement deficiency in familial SLE

A deficiency in complement component C5 is commonly associated with familial systemic lupus erythematosus (SLE). Complement deficiency is a hallmark of lupus, affecting the body's immune system.

Signup and view all the flashcards

Investigation for small ulcer, photosensitivity, fibrosis, and pigmentation

Testing for double-strand DNA antibodies is the most appropriate investigation for a patient with a small ulcer on a digit, photosensitivity, fibrosis, and pigmentation. These findings can be suggestive of systemic lupus erythematosus (SLE), an autoimmune disease.

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Investigation for calcinosis cutis

An X-ray is the most appropriate investigation for calcinosis cutis in the thigh in a renal patient. Calcinosis cutis is a condition characterized by calcium deposits in the skin.

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Investigation for photosensitivity

Testing for antinuclear antibodies (ANA) is the most appropriate investigation for a patient with photosensitivity. This test is often used to screen for autoimmune diseases, including lupus.

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Cancer associated with waxy brown papules on the trunk

Breast cancer is commonly associated with sudden waxy brown papules on the trunk in a 65-year-old female. These papules are a rare but significant sign of internal malignancy.

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Treatment for Gottron's rash and rash on the ear

Dapsone is the most appropriate treatment for a patient presenting with Gottron's rash on both hands and rash on the ear. These are characteristic symptoms of dermatomyositis, an inflammatory muscle disease.

Signup and view all the flashcards

Investigation to confirm JXG

Confirmation of a diagnosis of JXG association (Juvenile xanthogranuloma) is done through CD68 staining. JXG is a rare condition characterized by yellow or orange papules on the skin.

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Treatment for lichen sclerosus et atrophicus

Surgical removal is the most appropriate treatment for lichen sclerosus et atrophicus, though in some cases, the condition can be managed with topical steroids.

Signup and view all the flashcards

Specialist for amyloidosis

A patient with amyloidosis indicated by histopathology should be referred to a nephrologist. Amyloidosis is a rare condition characterized by the buildup of amyloid proteins in different parts of the body, often affecting the kidneys.

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Next step for lichen sclerosus et atrophicus

The next step in the management of lichen sclerosus et atrophicus is treatment with topical steroid (clobetasol). Lichen sclerosus is a common inflammatory condition that affects the skin.

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Treatment for persistent scarring in discoid lupus

Camouflage is the most appropriate treatment for a patient with discoid lupus and persistent scarring for 3 years. Discoid lupus is a chronic inflammatory autoimmune disease that mainly affects the skin.

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Management for asymptomatic maculopapular lesions

Symptomatic management is the appropriate approach for managing asymptomatic maculopapular lesions on the left arm. These lesions are commonly seen and may not require specific treatment.

Signup and view all the flashcards

Investigation for mixed connective tissue disease

Testing for Anti-RNP antibodies is the most relevant investigation for diagnosing mixed connective tissue disease in a patient presenting with sclerodactyly, Raynaud’s phenomenon, and photosensitivity.

Signup and view all the flashcards

Treatment for Encopé de Sabre

Treatment for Encopé de Sabre (saber cut) in a child involves subcutaneous Methotrexate (MTX). This condition is a form of linear scleroderma that affects the scalp, causing a scar-like furrow.

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What cancer is associated with waxy brown papules on the trunk?

Liver cancer is often associated with sudden waxy brown papules on the trunk in a 65-year-old female. These papules can be a rare but significant sign of internal malignancy.

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Treatment for brown macular rash on the cubital fossa

Topical steroids are the preferred treatment for brown macular rash on the cubital fossa in a female patient.

Signup and view all the flashcards

Medication for erythema, edema, and stiffness

Steroids are the most appropriate medication for treating erythema, edema, induration of the whole face, and stiffness of both lower limbs, along with periungual erythema. These symptoms are suggestive of a connective tissue disease like scleroderma or lupus.

Signup and view all the flashcards

Treatment for linear morphea in a child

Treatment for linear morphea in a 10-year-old child is a combination of steroids and MTX (methotrexate). Linear morphea is a type of scleroderma that primarily affects the skin.

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Protective treatment for pseudoxanthoma elasticum

NBUVB (narrowband ultraviolet B) is considered a protective treatment in a case of pseudoxanthoma elasticum. This is a rare genetic disorder that affects the skin, eyes, and blood vessels.

Signup and view all the flashcards

Investigation for mixed connective tissue disease

Testing for antinuclear antibodies (ANA) is the most relevant investigation for diagnosing mixed connective tissue disease in a patient presenting with sclerodactyly, Raynaud's phenomenon, and photosensitivity. It's a condition that often overlaps with other autoimmune diseases.

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Investigation for hypertrophic discoid lupus erythematosus

The key investigation to consider in hypertrophic discoid lupus erythematosus (DLE) with interface dermatitis and thickening basement membrane is a skin biopsy followed by direct immunofluorescence (DIF) and then a test for antinuclear antibodies (ANA). DLE is a chronic skin condition that primarily affects the face and scalp.

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Most common site for discoid lupus erythematosus

The most common site for discoid lupus erythematosus (DLE) is the face.

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What cancer is associated with waxy brown papules on the trunk?

Stomach cancer is often associated with sudden waxy brown papules on the trunk in a 65-year-old female. These papules can be a rare but significant sign of internal malignancy.

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Study Notes

Skin Conditions and Treatments

  • Sudden waxy brown papules on the trunk in a 65-year-old female are most associated with sebaceous gland carcinoma.
  • Brown macular rash on the cubital fossa in a female patient is best treated with topical steroids.
  • Erythema, edema, induration of the whole face, and stiffness of both lower limbs, along with periungual erythema in a patient, is best treated with systemic steroids.

Dermatological Conditions

  • Linear morphea in a 10-year-old child is best treated with steroids and physiotherapy.
  • Eruptive skin-colored papules with hardness on the face and upper back are best treated with isotretinoin.
  • Photosensitivity in connective tissue disease is best treated with hydroxychloroquine.

Autoimmune Disorders

  • Sarcoidosis with granuloma and few lymphocytes is best treated with biologic medications.
  • Dermatomyositis controlled on prednisolone and methotrexate (MTX) intake, with myopathy after one week, requires invasive electromyography as the next step.
  • Mixed connective tissue disease is diagnosed with anti-U1 RNP antibody.

Rare Skin Conditions

  • Familial systemic lupus erythematosus (SLE) is associated with complement deficiency.
  • Gottron rash on both hands and rash on the ear is best treated with systemic steroids.
  • Acquired digital fibrokeratoma is best treated with surgical excision.

Miscellaneous

  • In a case of amyloidosis, the patient should be referred to a hematologist.
  • In a case of discoid lupus, the most relevant investigation is histopathology.
  • In a case of hypertrophic discoid lupus erythematosus (DLE) with interface dermatitis and thickening basement membrane, the most relevant investigation is immunofluorescence.
  • Pseudoxanthoma elasticum is considered a protective treatment.
  • The expected complication in pseudoxanthoma elasticum is blindness.
  • Cutis laxa is diagnosed with genetic testing.

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Test your knowledge of dermatology with this quiz on connective tissue disorders, photosensitivity, granuloma, lymphocytes, and treatment options including steroids, biologics, and prophylactic measures. Evaluate your understanding of patient management and treatment decisions.

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