Papulosquamous Diseases and Pathology Quiz

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86 Questions

Which treatment modality is most appropriate for the patient with papulosquamous diseases as described in the text?

Phototherapy

Which histopathological feature is characteristic of PLEVA (pityriasis lichenoides et varioliformis acuta)?

Necrotic keratinocytes and extravasated RBCs

If a patient on NBUVB (narrowband UVB) therapy stops the session for 1 week, what is the recommended next step?

Increase dose

What is the causative drug commonly associated with the development of asymptomatic nodules in a patient with rheumatoid arthritis?

Methotrexate (MTX)

What is the most appropriate treatment for psoriasis in a child?

NBUVB therapy

In a patient with lesions (mostly psoriasis) and without insurance coverage, which treatment modality would be most suitable?

Methotrexate (MTX)

In a patient with dark brown multiple annular plaques, what is the most common site for this presentation?

Groin

Which drug is most likely to cause lichenoid drug eruptions in a patient with hypertension?

Captopril

In a patient with tiny skin colored papules on the hand resembling lichen nitidus, what is the commonest other site for this presentation?

Face

What is the next step if a patient with rheumatoid arthritis develops asymptomatic nodules while on adalimumab treatment?

Discontinue adalimumab and start TNF alpha inhibitor

Which treatment modality is commonly used for the management of lichen planus affecting the oral mucosa?

Tacrolimus

In a patient with psoriatic nails and palm, what is the recommended treatment if all nails are affected?

Biological therapy

In a female patient taking biologic treatment for 4 years with improvement, then presenting with scaly erythematous plaque and normal breast cancer investigations, what is the recommended next step?

Watch

In a case of knee with small tiny papules as L. nitidus associated with papules on wrist, what is the HLA marker of this disease?

HLA-ABC

In a psoriasis patient taking biologic treatment and presenting with bloody stool, which type of biologic treatment could be responsible for causing this symptom?

Secukinumab

In a patient with bloody diarrhea after taking secukinumab, what is the next recommended investigation?

Colonoscopy

In a 34-year-old patient with plaque psoriasis, what is the most effective treatment?

PUVA

What is the most likely diagnosis for localized scales in the scalp beside the ear with no hair loss and erythema?

Psoriasis if pityriasis amiantacea

In a patient with periumbilical umbilicated papules resembling molluscum and presenting with weight loss and CD4 count less than 200, what investigation is indicated?

PET scan if submandibular gland nodule present to search for primary tumor

What is the most suitable treatment for a patient with atopic dermatitis?

NBUVB

In a patient with renal transplantation who develops a maculopapular rash all over the body after 1 year, which virus is most likely responsible?

Polyomavirus

What period of preconception in weeks should be considered for a case of PRP?

6 weeks

What is the most appropriate treatment for a patient with multiple erythematous plaques, scaly papules, and no joint pain or itching for 3 months?

Acitretin

In a female patient with controlled psoriasis on biological therapy who is diagnosed with breast cancer, what is the appropriate next step?

Watch and wait

In a patient with eruptive skin papules on the trunk and chest with a thread-like border, which condition should be considered?

Precancerous

What is the appropriate treatment for pityriasis rubra pilaris (PRP)?

Retinoids

What is the histopathology typically seen in porokeratosis of Mibelli?

Parakeratosis and underlying hypogranulosis

In a patient with scleroderma-like lesions on the hand and knee, palmoplantar hyperkeratosis, and histopathological findings suggestive of porokeratosis, what is the most likely association?

An inflammatory condition

In a female patient with pityriasis rotunda, what neoplasm should be considered as an associated risk?

Gastric cancer

In a female patient with Bazex syndrome (scaly plaques on hands & feet, nose & ear involvement), what neoplasm should be considered as an associated risk?

Lung cancer

What is the most appropriate treatment for a patient with asymptomatic erythematous plaques covering >50% of body surface area and no back pain?

Narrowband UVB phototherapy

In a patient with plaque psoriasis and congestive heart failure living 100km away from the hospital, what is the best treatment option?

Phototherapy

In an adult female with skin-colored papules with induration on the face, trunk, and thighs (scleromyxedema), what would be the most appropriate treatment option?

Thalidomide

In a patient with known renal failure and generalized itchy hyperpigmented lesions resembling atrophic lichen planus, what would be the most appropriate treatment?

Narrowband UVB phototherapy

Which treatment modality is most suitable for a patient with papulosquamous diseases and no insurance coverage?

UV therapy

In a patient with eruptive skin papules on the trunk and chest with a thread-like border, which condition should be considered?

Pityriasis rosea

In a patient with tiny skin colored papules on the hand resembling lichen nitidus, what is the commonest other site for this presentation?

Genitalia

What is the most common site for dark brown multiple annular plaques in a patient?

Groin

If a patient on NBUVB (narrowband UVB) therapy stops the session for 1 week, what is the recommended next step?

Increase dose

In a patient with rheumatoid arthritis who developed asymptomatic nodules on the elbow and knee, which drug is most likely responsible?

Methotrexate

What is the most appropriate treatment for a patient with palmoplantar hyperkeratosis, hypopigmented lesions, and scaly erythematous papules?

Acitretin

In a female child with asymptomatic erythematous plaques covering more than 50% of the body surface area and no back pain, what is the recommended treatment for psoriasis?

Narrowband UVB

What is the best treatment option for a patient with plaque psoriasis and congestive heart failure living 100km away from the hospital?

Phototherapy

What would be the most appropriate treatment for a 35-year-old adult female with skin-colored papules, induration on the face, trunk, and thighs (scleromyxodema), and no IVIG administration?

Thalidomide

In a patient taking biologic treatment for 4 years with improvement, then presenting with scaly erythematous plaque and normal breast cancer investigations, what is the recommended next step?

MTX

What is the HLA marker of the disease associated with small tiny papules on the knee and wrist?

HLA-ABC

What type of keratin is associated with PPK trans gradient?

Keratin 10

In a patient with localized scales in the scalp beside the ear, with no hair loss and erythema, what is the most likely diagnosis?

Seborrheic dermatitis

What is the histopathology typically seen in lichen planus of the nail?

Keratinocyte necrosis

In a patient taking biologic treatment who presents with bloody stool, which type of biologic treatment could be responsible for causing this symptom?

Secukinumab

In a patient with renal transplantation who develops a maculopapular rash all over the body after 1 year, which virus is most likely responsible?

Polyoma

Which epidermal differentiated keratinocytes are typically associated with K1,10?

K1,10

What is the appropriate treatment for a patient with known renal failure and generalized itching, hyperpigmentation?

NBUVB

In a patient with plaque psoriasis controlled on infliximab then becomes uncontrolled on infliximab, what is the next step (secondary failure)?

Shift to another biologic

In a psoriatic patient taking biologic treatment and presenting with bloody stool, which type of biologic treatment could be responsible for causing this symptom?

Secukinumab & ixekizumab & brodalimumab

In a female patient on certolizumab who becomes pregnant, what is the recommended action?

Stop

Which treatment modality is most appropriate for the management of a patient with asymptomatic nodules on the elbow and knee caused by rheumatoid arthritis?

Methotrexate

If a patient with rheumatoid arthritis develops asymptomatic nodules on the elbow and knee, which drug is most likely responsible?

Methotrexate

In a patient with dark brown multiple annular plaques, what is the most common site for this presentation?

Leg if pityriasis rotunda

What is the next step if a patient on NBUVB (narrowband UVB) therapy stops the session for 1 week?

Increase dose

A patient with rheumatoid arthritis developed asymptomatic nodules on the elbow and knee. What is the causative drug?

Methotrexate

What would be the most appropriate treatment for a child with psoriasis?

NBUVB

In a patient with lesions (mostly psoriasis) and without insurance coverage, which treatment modality would be most suitable?

Methotrexate

What is the commonest other site for tiny skin colored papules as lichen nitidus, apart from the hand?

Face

If a patient with papulosquamous diseases stopped NBUVB therapy for 1 week, what is the recommended next step?

Increase dose

In a patient with hypertension and lichenoid drug eruptions, what is the causative drug?

Captopril

A patient with rheumatoid arthritis developed asymptomatic nodules on the elbow and knee. What would be the most effective treatment?

Methotrexate

What is the causative drug commonly associated with the development of asymptomatic nodules in a patient with rheumatoid arthritis?

Methotrexate

Which investigation is indicated for an old male patient with MF histopathology showing Partueir microabscess and CT scan with LN enlargement?

T cell receptor rearrangement in tissue

What is the FDA approved drug for a case scenario of MF cd 30 positive?

Brentuximab

In a patient with asymptomatic erythematous plaques covering more than 50% of the body surface area and no back pain, what is the recommended treatment for psoriasis?

Narrowband

For an adult female with skin-colored papules with induration on the face, trunk, and thighs (scleromyxedema), what would be the treatment option?

IVIG

In a patient with eruptive skin papules on the trunk and chest with thread-like border (porokeratosis or seborrheic keratosis), what condition should be considered?

Precancerous

What is the characteristic histopathology of porokeratosis of Mabili?

Parakeratosis and underlying hypergranulosis

Which type of keratin is associated with PPK (palmoplantar keratoderma)?

Type 4

In the picture of nail psoriasis, what type of associated disease is indicated?

Arthritis

In the case of a female patient taking biologic treatment for 4 years with improvement, then presenting with scaly erythematous plaque and normal breast cancer investigations, what is the recommended next step?

Watch

If a patient taking biologic treatment experiences bloody stool, which type of biologic treatment could be responsible?

Secukinumab

In a patient with renal transplantation who develops a maculopapular rash all over the body, which virus is most likely involved?

Polyoma

In a patient with lichen planus involving the nails, what is the typical histopathology?

Hypergranulosis

In a patient with periumbilical umbilicated papules resembling molluscum and presenting with weight loss and CD4 count less than 200, what investigation is indicated?

(PET) scan if SMJ nodule to search for primary tumor.

What is the most effective treatment of plaque psoriasis in a 34-year-old patient?

(PUVA)

In a case of localized scales in the scalp beside the ear with no hair loss and erythema, what is the most likely diagnosis?

(Psoriasis) if pityriasis amentia

(LP) Lichen planus case histopathology is characterized by:

(Hypergranulosis)

For patients with GVHD (chronic type), what biologic treatment is recommended?

Anti CD20: rituximab

What epidermal differentiated keratinocytes are typically associated with K1,10?

K1,10

Test your knowledge of papulosquamous diseases and their treatments. Identify the appropriate treatment for a patient with a papule and necrotic center, as well as the pathology features of PLEVA/PLC. Evaluate your understanding of different treatment options and pathological characteristics.

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