vesicular and bullous dermatosis mcqs

8/11/2019 Vesicular and Bullous Dermatosis MCQs

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A 29 year old female patient is diagnosed with fogo selvagem. The likely possibility that this personwith die within two years is :

1 90%

2 70%

3 40%

4 20%

5 10%

Q/Q(M)-482895 Report a Problem A 29 year old female patient is diagnosed with fogo selvagem. The likely possibility that this personwith die within two years is :

3 40%

Patients with fogo selvagem have a 40% of dying within 2 years with they do not receive treatment.These patient have burning lesions that is denuded with roll of pushed back upper epidermis at

periphery. Patients can also develop erythrodermaQ/Q(M)-482895 Report a Problem

The rate limiting step in the porphyria pathway is mediated by the enzyme:

1 Ferrochetalase

2 ALA dehydratase

3 ALA synthase

4 Uroporphyrinogen decarboxylase5 Porphobilinogen deaminase

Q/Q(M)-474613 Report a Problem The rate limiting step in the porphyria pathway is mediated by the enzyme:

3 ALA synthase

ALA synthase mediates the first and rate-limiting step in the heme synthesis pathway. This step occursin the mitochondria and allows for the conversion of Succinyl coA + glycine to delta aminolevilinicacid.

Q/Q(M)-474613 Report a Problem The most common cause of contact dermatitis in the United States is:

1 Hair dyes

2 Nickel

3 Nail lacquers

4 Toxicodendrons

5 Rubber

Q/Q(M)-478699 Report a Problem

The most common cause of contact dermatitis in the United States is:


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4 Toxicodendrons

The most common cause of contact dermatitis in the USA are (in order of most to least common):toxicodendrons (poison ivy, oak, or sumac), nickel, fragrance, thimerosal, quarternium-15, neomycin,formaldehyde and the formaldehyde-releasing preservatives, bacitracin, and rubber compounds.


Which of the following allergens is a non-formadelhyde releasing preservative with a low sensitization potential?

1 Methylisothiazolone

2 Paraben

3 Bronopol

4 Quternium-15

5 DMDM hydantoin


Which of the following allergens is a non-formadelhyde releasing preservative with a low sensitization potential?

2 Paraben

Paraben mix is a non-mercurial, non-formaldehydge releasing preservative with low sensitization potential. Methylisothiazolone is a non-formaldehydge releasing preservative found in wash-on/wash-off products. The others are formaldehyde-releasing preservatives.


Which of the following is the most common photoallergen?

1 octyl dimethyl PABA

2 Dihydroxyacetone

3 Benzophenone

4 Oxybenzone

5 glyceryl thioglycolateQ/Q(M)-474140 Report a Problem

Which of the following is the most common photoallergen?

4 Oxybenzone

Oxybenzone is a UVA sunscreen and is the most common photoallergen. Octyle dimethyl PABA(Padimate O) and benzophenone are also sunscreen agents, and both can also cause contact dermatitis.Dihydroxyacetone is a sunless-tanning agent and glyceryl thioglycolate is found in permanent wavesolutions.



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The lamina densa is primarily composed of?

1 Connexins

2 Plectin

3 Collagen XVII4 Collagen VII

5 Collagen IV


The lamina densa is primarily composed of?

5 Collagen IV

Collagen IV is located in the dermal matrix and forms the anchoring plaque. The anchoring plaqueserves to anchor the lamina densa to the dermis via collagens 1,3 & 5.


Allergic contact dermatitis is characterized histologically by:

1 Psoriasiform dermatitis

2 Lichenoid infiltrate

3 Spongiosis

4 Parakeratosis5 Granuloma


Allergic contact dermatitis is characterized histologically by:

3 Spongiosis

Spongiosis refers to the accumulation of edema fluid between keratinocytes, in some cases progressingto vesicle formation. The epidermis acquires a "spongy" appearance. This histopathologic pattern ofinflammation is usually accompanied by an infiltrate of lymphocytes within the epidermis and aroundsuperficial vessels. In addition to spongiosis, allergic contact dermatitis is typically accompanied byeosinophils.


The primary autoantigen in pemphigoid gestationis is

1 Desmoplakin

2 BPAG1

3 BPAG2

4 Plakoglobin


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5 Anchoring fibrils


The primary autoantigen in pemphigoid gestationis is

3 BPAG2Herpes gestationsis is an autoimmune blistering disorder of pregnancy. It is characterized by urticarial

plaques and tense bullae. Antibodies to BPAG2 are thought to form as a result of an aberreant responseto MHC antigens on the placenta. The maternal health is generally not affected, but infants are morecommonly born premature. Remission is common following delivery, but it may recur with OCP's,menstruation, and subsequent pregnancies.


Which type of porphyria disease is most likely to be associated with cholelithiasis?

1 Acute intermittent porphyria

2 Congenital erythropoeitic porphyria

3 Hereditary coproporphyria

4 Erythropoetic protoporphyria

5 Variegate porphyria


Which type of porphyria disease is most likely to be associated with cholelithiasis?

4 Erythropoetic protoporphyria

Erythropoeitic protoporphyria is caused by a defect in the enzyme ferrrochetalase. Patients present withimmediate photosensitivity and subsequently develop waxy scarring on the face, hands and knuckles. Inaddition to abdominal pain, cholelithiasis and liver disease may also occur. The porphyria diseasesassociated with abdominal pain are acute intermittent porphyria, hereditary coproporphyria andvariegate porphyria. Congenital erythropoeitc porphyria is associated with splenomegaly.


The genetic predisposition for patients with pemphigus vulgaris is:

1 HLA-DRQ402

2 HLA-DR33 HLA-DR4

4 HLA-0505

5 HLA-Bw3


The genetic predisposition for patients with pemphigus vulgaris is:

1 HLA-DRQ402

Patients with HLA-DRQ402 can be predisposed to the development of pemphigus vulgaris. Pemphigusvulgaris is a severe potentially fatal disease with blister formation on the skin and the mucosa


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4 Plakoglobin

5 Desmoplakin I and desmoglein 3


Antibodies in some forms of Stevens-Johnson bind to:

1 Desmoplakin I

Antibodies against desmoplakin I and II have been found in Stevens-Johnson.Q/Q(M)-474622 Report a Problem

This is found in both desmosomes and adherens junctions:

1 Alpha-catenin

2 Desmoglein 3

3 Desmoglein 1

4 Plakoglobin

5 Lamin


This is found in both desmosomes and adherens junctions:

4 Plakoglobin

Plakoglobin is a plaque protein of the armadillo family that is found in desmosomes; it can alsosubstitute for beta-catenin in adherens junctions. Plakoglobin co-precipitates with desmogleins. It is 85

kDa.Q/Q(M)-474658 Report a Problem

The dimethylglyoxime test is used to detect the presence of:

1 Gold

2 Silver

3 Mercury

4 Nickel

5 LatexQ/Q(M)-474612 Report a Problem

The dimethylglyoxime test is used to detect the presence of:

4 Nickel

1% dimethylglyoxime is added to to the metal. If a red precipitate forms, there is >1:10000 nickelcontent.


Which pair is incorrect?

1 Desmoglein 1 : 160 kDa


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2 Desmoplakin I : 250 kDa

3 Type VII collagen : 290 kDa

4 Type XVII collagen: 180 kDa

5 Envoplakin : 190 kDa



5 Envoplakin : 190 kDa

Envoplakin is 210 kDa. Periplakin is 190 kDa.Q/Q(M)-474641 Report a Problem

Drugs that are associated with the exacerbation of pemphigus foliaceus include :

1 Captopril

2 Metoprolol3 Fluconazole

4 Calcium channel blockers

5 Statins



1 Captopril

Pemphigus foliaceus is a form of pemphigus with superficial blisters. The autoantibodies are againstDsg1. Medications associated with the exacerbation of pemphigus foliaceus is sulfhydryl groups such ascaptopril, penicillamine and piroxicam. Metroprolol can exacerbate psoriasis.


A 60 year old gentleman presents with a recurrent pustular eruption. Biopsy demonstrates subcorneal pustules with abundant neutrophils and a serum protein electrophoresis shows a monoclonal IgAgammopathy. The autoantigen responsible for this condition:

1 Desmoglein I

2 Desmocollin I

3 Desmoplakin

4 Plakoglobin

5 Beta 4 integrin


A 60 year old gentleman presents with a recurrent pustular eruption. Biopsy demonstrates subcorneal pustules with abundant neutrophils and a serum protein electrophoresis shows a monoclonal IgA

gammopathy. The autoantigen responsible for this condition:2 Desmocollin I


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Sneddon-Wilkenson (subcorneal pustular dermatosis) is a variant of IgA pemphigus. Clinically, patientshave pustules arranged in annular and serpiginous pattern on the abdomen, axilla, and groin. The antigenis desmocollin 1 and 2. Treatment options include acitretin and dapsone.


Patients with latex allergy are LEAST LIKELY to develop a reaction to:

1 Cashew

2 Avocado

3 Chestnut

4 Banana

5 Kiwi


Patients with latex allergy are LEAST LIKELY to develop a reaction to:

1 Cashew

Although rare, cross-reactivity in latex-allergic patients has been demonstrated to banana, kiwi, avocado, passion fruit, and chestnut. Cross-reaction to cashew has NOT been reported.


Fiberglass dermatitis can be prevented by:

1 Water

2 Acetic acid 5%

3 Sodium chloride

4 Alkali

5 Talcum powder


Fiberglass dermatitis can be prevented by:

5 Talcum powder

Talcum powder application causes fiberglass spicules to slide off skin.Q/Q(M)-474655 Report a Problem

Leiner's disease (erythroderma desquamativum) is associated with:

1 C5-9 deficiency

2 Numerous infections

3 Diarrhea

4 Numerous infections and diarrhea

5 All of these answers are correct


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Leiner's disease (erythroderma desquamativum) is associated with:

4 Numerous infections and diarrhea

Leiner's disease is associated with deficient C5 and possibly C3. Babies with this disease are prone to

diarrhea, infections (sepsis), anemia, and a generalized seborrheic dermatitis-like rash.Q/Q(M)-474626 Report a Problem


1 Captopril

2 Metoprolol

3 Fluconazole

4 Calcium channel blockers

5 Statins



1 Captopril

Pemphigus foliaceus is a form of pemphigus with superficial blisters. The autoantibodies are againstDsg1. Medications associated with the exacerbation of pemphigus foliaceus is sulfhydryl groups such ascaptopril, penicillamine and piroxicam. Metroprolol can exacerbate psoriasis.


The picture shown is considered to be diagnostic for what type of epidermolysis bullosa

1 Junctional epidermolysis bullosa- Non Herlitz type

2 Junctional epidermolysis bullosa- Herlitz type

3 Dowling-Meara form of Epidermolysis Bullous simplex

4 Dominant dystrophic epidermolysis bullosa

5 Recessive dystrophic epidermolysis bullosa


The picture shown is considered to be diagnostic for what type of epidermolysis bullosa


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5 Recessive dystrophic epidermolysis bullosa

The picture is shown is know as "mitten hands" and is diagnostic for recesseive type of dystrophicepidermolysis bullosa. RDEB have the Hallopeau-Siemens type, a severe life-altering bullous diseasecharacterized by widespread dystrophic scarring and deformity and by severe involvement of mucousmembranes. Much less commonly, RDEB may manifest as the non-Hallopeau-Siemens types, a mildlocalized form (mitis), and an inverse variant (recessive epidermolysis inversa). In the Hallopeau-Siemens form of RDEB, erosions and blisters are usually manifested at or shortly after birth. Blistersmay appear to occur spontaneously, but most seem to arise at sites of pressure or trauma. Nikolsky signis often positive. The hands and lower aspects of the legs are particularly susceptible to severe blisteringand scarring. The fingers and toes may become fused, with resultant pseudosyndactyly, in which thedigits become bound together by a glove-like epidermal sac, with resulting claw-like clubbing or mitten-like deformities as shown in the image.


Common drugs causing SJS/TEN include all except:

1 Sulfonamides

2 Carbamazepime

3 Allopurinol

4 Oxicam

5 Colchicine


Common drugs causing SJS/TEN include all except:

5 Colchicine

NSAIDs, anticonvulsants, allopurinol, and sulfa drugs are common inciting agents of SJS/TEN.Q/Q(M)-474635 Report a Problem

Bullous pemphigoid antigen 1 (BPAg1) is a member of this family:

1 Cadherin

2 Integrin

3 Intermediate filament

4 Plakin

5 Selectin


Bullous pemphigoid antigen 1 (BPAg1) is a member of this family:

4 Plakin

The plakin family includes desmoplakin I and II, BPAg1, envoplakin, periplakin.Q/Q(M)-474098 Report a Problem

What is the most common allergen causing allergic contact dermatitis?

1 Nickel


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2 Bacitracin

3 Formaldehyde

4 Quaternium-15

5 Neomycin


What is the most common allergen causing allergic contact dermatitis?

1 Nickel

Nickel is the most common contact allergen, found in costume jewelry, alloys, pigments orthopedicappliances, scissors, razors and many other metal coated objects. Bacitracin and neomycin arecommonly used topical antibiotic agents that many are allergic to. Neomycin is the most commontopical antibiotic allergen found in testing. Quaternium-15 is a formaldehyde-releasing preservativefound in many topical products. It can cross react with formaldehyde, but not all patients will react toformaldehyde on testing. While it is a common allergen, it is not the most common cause of ACD.


The ocular form of cicatricial pemphigoid is most likely to be associated with antibodies to:

1 Beta-4-integrin

2 Laminin 5

3 BPAg1

4 BPAg2-NC16A

5 Plectin


The ocular form of cicatricial pemphigoid is most likely to be associated with antibodies to:

1 Beta-4-integrin

Antibodies to beta-4-integrin are associated with ocular cicatricial pemphigoid. Laminin 5 is associateda variant of cicatricial pemphigoid that is associated with malignancy. BPAg1 is the antigen in bullous

pemphigoid, while BPAg2-NC16A is associated with both bullous pemphigoid and herepes gestationis.Mutations in plectin are associated with epidermolysis bullosa acquisita with muscular dystrophy.


Mutations in beta-catenin are most commonly associated with:

1 Naxos disease

2 Bullous pemphigoid

3 Pilomatricomas

4 Ectodermal dysplasia with skin fragility

5 Ocular cicatricial pemphigoid



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Mutations in beta-catenin are most commonly associated with:

3 Pilomatricomas

The armadillo family of proteins constitute of group of proteins which function in cellular adhesion.These include beta catening, plakoglobin and plakophilins. Mutations in beta-catenin have beenassociated with some pilomatricdomas and colorectal carcinomas. Naxos disease has been linked to amutation in plakoglobin, while ectodermal dysplasia with skin fragility has beenlinked to a mutation in

plakophilin 1. Ocular cicatricial pemphigoid is associated with antibodies to beta4-integrin.Q/Q(M)-474184 Report a Problem

Pemphigus erythematosus:

1 Is also called Hallopeau syndrome

2 May be an abortive form of subcorneal pustulosis

3 Is often in a malar/seborrheic distribution

4 Does not have linear IgG and C3 at the basement membrane zone

5 All of these answers are correctQ/Q(M)-474636 Report a Problem

Pemphigus erythematosus:

3 Is often in a malar/seborrheic distribution

Pemphigus erythematosus, or Senear Usher syndrome, presents like pemphigus foliaceus and lupuserythematosus with very superficial erosions and erythematous/hyperkeratotic facial/chest lesions. DIFreveals intercellular IgG and linear IgG at the dermoepidermal junction.


Which of the following is LEAST LIKELY to cross react with Toxicodendron plant dermatitis?

1 Japanese lacquer tree

2 Cashew nut

3 Mango rind

4 Gingko tree

5 Kiwi


Which of the following is LEAST LIKELY to cross react with Toxicodendron plant dermatitis?

5 Kiwi

The Toxicodendron group of plants is the #1 cause of contact dermatitis in North America. This groupof plants includes poison ivy, poison oak, and poison sumac. Because the Toxicodendron plants belongto the Anacardiaceae family, cross reactions can occur with related plants and substances such as

braqzilian pepper, cashew nut, cashew oil, gingkgo tree, Indian marking nut, Japanese lacquer tree,mango, and Rengas tree. Kiwi can cross react with patients who are latex-allergic.



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Patients with this disorder may develop exaggerated reactions to insect bites:

1 Chronic lymphocytic leukemia


3 Lupus erythematosus4 Atopic dermatitis

5 Incontinentia pigmenti


Patients with this disorder may develop exaggerated reactions to insect bites:


Patients with chronic lymphocytic leukemia may develop exaggerated reactions to insect bites, including bullous reactions.


Pinus palustris is the source of:

1 Urea

2 D-limonene

3 Quinones

4 Lactones5 Abietic acid


Pinus palustris is the source of:

5 Abietic acid

Abietic acid is the allergenic component of rosin (colophony). D-limonene is found in tea tree oil.Primin is a quinone; it is found in the primrose (Primula obconica). Abietic acid is found in rosin.


Papillary dermal deposits of IgA and a papillary dermal infiltrate of neutrophils is diagnostic of:

1 Sweet's syndrome

2 Leukocytoclastic vasculitis

3 Dermatitis herpetiformis

4 Linear IgA dermatosis



Papillary dermal deposits of IgA and a papillary dermal infiltrate of neutrophils is diagnostic of:


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3 Dermatitis herpetiformis

Dermatitis herpetiformis is an uncommon chronic, pruritic papulovesicular dermatitis occurring mostcommonly in young to middle-aged adults. Common sites of predilection include the buttocks, elbows,knees, scapula and scalp. Typical histologic features include accumulation of neutrophils at the tips ofdermal papillae, sometimes admixed with eosinophils. Direct immunoflorescence (DIF) reveals granulardeposits of IgA within the dermal papillae. As the name implies, linear IgA disease is characterized bylinear IgA deposition along the basement membrane zone with DIF in 100% of cases. The pattern ofdirect immunoflorescence in bullous pemphigoid is linear C3 deposition at the dermoepidermal junctionin nearly 100% of cases and IgG in 65-95% of cases. Sweet's syndrome is not characterized by a patternwith DIF. Under light microscopy, a dense perivascular infiltrate of neutrophils is seen assuming a

bandlike pattern throughout the papillary dermis associated with prominent dermal edema.Leukocytoclastic vasculitides are characterized by a perivascular neutrophilic infiltration withkaryorrhexis, leukocytoclasis, fibrinoid degeneration, and endothelial swelling.


Which of the following proteins is a 160kDa cadherin?

1 Desmoglein 3

2 Desmoglein 1

3 Desmoplakin I

4 Envoplakin

5 Plectin


Which of the following proteins is a 160kDa cadherin?

2 Desmoglein 1Desmogleins and desmocollins belong to the cadherin family of proteins, which are calcium-dependentadhesion molecules. Desmoglein I is a 160kDa cadherin, while Desmoglein 3 is a 130 kDa cadherin.Desmoplakin, envoplakin, and plectin belong to the plakin family of adhesion proteins.



1 Dermatitis herpetiformis : granular IgA

2 Lichen planus : linear C3

3 Bullous pemphigoid : linear C3

4 Systemic lupus erythematosus : linear IgG

5 IgA pemphigus: intercellular IgA



2 Lichen planus : linear C3

The colloid bodies in lichen planus can trap IgM and C3; this can be seen on DIF as globs. There isno linear pattern.


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What is the enzyme defect in Gunther's disease?

1 Porphobilinogen deaminase

2 Uroporphyrinogen synthetase III3 Uroporphyrinogen decarboxylase

4 Ferrochetalase

5 Protoporphyrinogen oxidase


What is the enzyme defect in Gunther's disease?

2 Uroporphyrinogen synthetase III

Gunther's disease (also known as congenital erythropoietic porphyhria) is caused by a defect inuroporphyrinogen synthetase II, the enzyme which responsible for the conversion ofhydroxymethylbilane to uroporphyriogen III. Patients present with red teeth and immediate

photosensitivy during infancy. There is severe photophobia and late skin manifestations includemutilating scarswith scarring alopecia, and sclerodermoid changes.


Cicatricial pemphigoid can be induced by:

1 Aminoglycosides

2 Benzene

3 Clonidine

4 Vancomycin

5 Ciprofloxacin


Cicatricial pemphigoid can be induced by:

3 Clonidine

Clonidine is a cause of drug-induced cicatricial pemphigoid. Other common causes includee sulfa drugsand thiol-containing drugs.


Which of the following concerning Degos' Disease is true?

1 After undergoing multiple stages, it resolves without scarring

2 It affects women more than men

3 Gatrointestinal involvement is a poor prognosis4 Glucocorticoids are standard of treatment


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5 Lab results indicate a low plasma fibrinogen level and decreased platelet aggregation


Which of the following concerning Degos' Disease is true?

3 Gatrointestinal involvement is a poor prognosisDego's Disease (Malignant Atrophic Papulosis): It most frequently affects men and is a potentially fatalobliterative arteritis. After undergoing multiple stages, the patient is left with varicelliform scars. Later,anemic infarcts involve the intestines to produce acute abdominal symptoms of epigastric pain, fever,and hematemesis. Death is usually due to fulminating peritonitis caused by multiple perforations of theintestines. GI involvement is a poor prognosis. Lab results indicate a high plasma fibrinogen level andincreased platelet aggregation. Administration of corticosteroids has not been beneficial.


In Brunsting-Perry pemphigoid, the recrurrent crops of blisters are most likely to appear on:

1 Genitals

2 Palms and soles

3 Umbilicus

4 Head and neck

5 Buttocks


In Brunsting-Perry pemphigoid, the recrurrent crops of blisters are most likely to appear on:4 Head and neck

Brunsting-Perry pemphigoid is a variant of cicatricial pemphigoid in which there are no mucosal lesions.The most common site of blisters is the head and neck, resulting in scarring alopecia. The antigens incicatricial pemphigoid include BPAg2 and epiligrin.


Which type of porphyria manifests with peripheral neuropathy, colicky abdominal pain, but NOcutaneous symptoms?

1 Acute Intermittent Porphyria

2 Gunther's disease


4 Hereditary Copropophyria

5 Erythropoietic protopophyria


Which type of porphyria manifests with peripheral neuropathy, colicky abdominal pain, but NO

cutaneous symptoms?1 Acute Intermittent Porphyria


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Acute intermittent pophyria is caused by a defect in the enzyme porphobilinogen deaminase. Patients present with peripheral neuropathy and occasionally seizures, abdominal pain, and tachycardia. Thereare no skin changes as no dermal porphyrins are found.


Bullous lupus erythematosus is most commonly associated with antibodies to:

1 Type XII collagen

2 Type VII collagen

3 Plectin

4 Desmoglein I

5 Laminin 5


Bullous lupus erythematosus is most commonly associated with antibodies to:2 Type VII collagen

Type VII collagen is found in the sublamina densa and patients with bullous lupus erythematosus have been found to have antibodies to this protein. The histology can resemble that of dermatitisherpetiformis and DIF shows linear IgG, IgM, IgA and C3.


What is the most common site of involvement of this autoimmune blistering disease?

1 Oral mucosa

2 Eyes

3 Skin

4 Genitalia

5 Nasopharyngeal mucosa


What is the most common site of involvement of this autoimmune blistering disease?

1 Oral mucosa

Cicatricial pemphigoid is a heterogeneous group of diseases with characteristic involvement of the oralmucosa, eyes, skin. Rarely, it can also involve the nasopharyngeal mucosa, external genitalia,esophagus, and anus. The oral mucosa is the most common site of involvement.



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Which of the following substances is known to cause a delayed positive patch test reaction?

1 Gold

2 Nickel

3 Bacitracin

4 Fragrance mix

5 Rosin


Which of the following substances is known to cause a delayed positive patch test reaction?

1 Gold

Gold is known to cause a delayed patch test reading. Patients allergic to gold often also react to nickeland cobalt. Bacitracin is a frequent contact allergen that often coexists with an allergy toneomycin. Fragrance mix contains cinnamic alcohol and aldehyde, hydroxycitronellel, isoeugenol,eugenol, oak moss absolute, alpha-amyl cinnamic aldehyde, geraniol. Rosin (colophony) is found inadhesive tape, cosmetics, glossy papers, violin bows, and chewing gum.


The antigen in linear IgA is:

1 BPAg1

2 Plectin

3 97kDa part of BPAg2

4 Laminin 55 Alpha-6, beta integrin


The antigen in linear IgA is:

3 97kDa part of BPAg2

The antigen in linear IgA and its variant, chronic bullous disease of childhood, is the 97kDa part ofBPAg2. BPAg1 is the antigen in bullous pemphigoid. Plectin is defective in EB simplex with musculardystrophy. Laminin 5 is defective in junctional EB and alpha 6, beta integrin is defective in junctionalEB with pyloric atresia.


Th2-related cytokines include:

1 IL10

2 IFNgamma

3 IFNalpha

4 IL10 and IFNgamma5 All of these answers are correct


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Th2-related cytokines include:

1 IL10

Atopic dermatitis is considered a disease in which a Th2 pattern predominates, especially early on. Th2cytokines are IL4, IL5, IL6, IL10, IL13.Q/Q(M)-474627 Report a Problem

The epidermolysis bullosa acquisita antigen is:

1 A transmembrane protein

2 An intracellular protein

3 A desmosomal protein

4 Located in the lamina lucida

5 An anchoring fibril


The epidermolysis bullosa acquisita antigen is:

5 An anchoring fibril

Epidermolysis bullosa acquisita is a rare autoimmune disorder with an estimated incidence of 0.25 permillion. In the classic form, it is characterized by non-inflammatory bulla with a prediliction fortraumatized sites. The autoantigen is type VII collagen, which is an anchoring fibril located in thesublamina densa. Following salt split skin, the type VII collagen can be localized at the base.


A child has a defect in type VII collagen and presents with acral blisters which heal with milia andscarring. What is the diagnosis?

1 Albopapuloid/Pasini variant of dystrophic epidermolysis bullosa

2 Bart's syndrome

3 Cockayne-Touraine disease

4 Epidermolysis bullosa acquisita

5 Weber-Cockayne


A child has a defect in type VII collagen and presents with acral blisters which heal with milia andscarring. What is the diagnosis?

3 Cockayne-Touraine disease

This patient has Cockayne-Touraine disease which is characterized by a defect in type VII collagen and presents with acral blisters which heal with milia and scarring. The albopapuloid variant of dystrophicepidermolysis bullosa presents with flesh-colored, scar-like papules and dystrohpic nails. Bart'ssyndrome is associated with aplasia cutis congenita usually on the extremities. Weber-Cockayne does


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have acral lesions but it is associated with a defect in keratins 5 and 14. The pathogenesis ofepidermolysis bullosa acquisita involves autoimmunity to collagen VII, not a defect in it.

Q/Q(M)-482367 Report a Problem Which of the following is true of herpes gestationis?

1 Demonstrates antibodies to the C-terminal domain of BPAg2

2 Has higher frequency in females with HLA-DQ2

3 Is associated with Grave's disease

4 Usually occurs in the first trimester of pregnancy

5 Shows subepidermal bullae mostly with neutrophils


Which of the following is true of herpes gestationis?

3 Is associated with Grave's disease

Herpes gestationis is associated with Grave's disease. It is more common with patients with HLA-DR3and DR4 and most often occurs between 4-7 months of pregnancy. The antibodies are against the NC16-A portion of BPAg2. Histology shows subepidermal bullae with mostly eosinophils.


A 59-year old female has erythema and vesiculation in an area of application of tincture of benzoin.Which allergen is she also most likely allergic to?

1 Ammonium persulfate

2 Black rubber mix

3 Balsam of Peru

4 Eugenol

5 Epoxy resin


A 59-year old female has erythema and vesiculation in an area of application of tincture of benzoin.Which allergen is she also most likely allergic to?

3 Balsam of PeruThis patient who has a contact dermatitis to tincture of benzoin is probably reacting to its allergenicingredient Balsalm of Peru which has healing and antibacterial properties. Ammonium persulfate is a

bleaching agent for hair and flour, not to be confused with ammonium thioglycolate, a perming agent.Black rubber mix can produce unique lichenoid and purpuric reactions. Eugenol is found in cloves.Epoxy resin is found in glues and plastics.


Which of the associated antigens for this condition has been associated with colon cancer?

1 Anti-epiligrin

2 97 kD linear IgA dermatosis antigen

3 Desmoplakin


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4 Bullous pemphigoid antigen 2

5 Beta-4 integrin


Which of the associated antigens for this condition has been associated with colon cancer?

1 Anti-epiligrin

While the oral mucosa is the most common site for cicatricial pemphigoid, ocular involvement is verycommon. Clinical manifestations may include shortened fornices, symblephera, ankyloblephera. Themajority of of ocular antigens are thought to reside in the cytoplasmic domain of beta-4 integrin.


Bullous lesions are seen in:

1 Congenital syphilis

2 Primary syphilis

3 Secondary syphilis

4 Tertiary syphilis5 All of these answers are correct

Q/Q(M)-474074 Report a Problem Bullous lesions are seen in:

1 Congenital syphilis

Congenital syphilis, but not other forms of syphilis, can occasionally present with bullae.Q/Q(M)-474074 Report a Problem

A 35 year-old dentist presents with tingling in his fingertips. What allergen is most likely to cause thisdermatitis?

1 Methyl methacrylate

2 Paraphenylenediamine

3 Colophony

4 Thiuram mix

5 Ethylenediamine dihydrochloride



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A 35 year-old dentist presents with tingling in his fingertips. What allergen is most likely to cause thisdermatitis?

1 Methyl methacrylate

Methyl methacrylate is found in synthetic resins, dentures, artificial, nail adhesives, and acrylic bonecement. This allergen may penetrate through the gloves to the fingertips and most often affects the firstthree fingers. In addition to dermatitis, it also causes a peripheral neuropathy.


At what level is the blister separation plane in linear IgA dermatosis?

1 Granular layer

2 Suprabasal layer

3 Basal layer

4 Lamina lucida5 Lamina densa


At what level is the blister separation plane in linear IgA dermatosis?

4 Lamina lucida

The cleavage in linear IgA dermatosis (LAD) typically occurs in the lamina lucida as the target antigenis the 97 kD cleaved portion of bullous pemphigus antigen II (BPAgII). A variant of LAD may separate

in the sublamina densa, with a target antigen of the type VII collagen in the anchoring fibrils. Thiscondition may also be induced by ingestion of certain medications including vancomycin, lithium anddiclofenac.


Which neoplasm is the most common cause of paraneoplastic pemphigus?

1 Thymoma

2 CLL

3 Castleman's disease

4 Retroperitoneal sarcoma

5 Non-Hodgkin's lymphoma


Which neoplasm is the most common cause of paraneoplastic pemphigus?


All of the above have been associated with paraneoplastic pemphigus with non-Hodgkin's lymphoma being the most common. Castlemans's disease is most common in children with paraneoplastic pemphigus.


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Irritation of the hand produced by capsaicin can be relieved by application of

1 Water

2 Acetic acid 5%

3 Sodium chloride

4 Alkali

5 Talcum powder


Irritation of the hand produced by capsaicin can be relieved by application of

2 Acetic acid 5%

Burning secondary to capsaicin can be relieved by vinegar (acetic acid 5%) as the capsaicin is soluble invinegar (but not water).Q/Q(M)-474654 Report a Problem

Which of the following contains the same allergen as poison sumac?

1 Mango fruit

2 Brazilian Pepper Tree

3 Balsam of Peru

4 Ragweed

5 Artichoke


Which of the following contains the same allergen as poison sumac?

2 Brazilian Pepper Tree

The rhus family (poison ivy, poison oak, poison sumac) contain urushiol (a pentadecacatechol). Thisallergen is also associated with contact allergy to Cashew nut, Japanese laquer tree, Mango rind (not

fruit), Gingko, Brazilian pepper tree, Pepeo tree of Venezuela, El litre tree of Chile and the Rengas(black varnish) tree.Q/Q(M)-482457 Report a Problem

Circulating autoantibodies to type XVII collagen are most characteristic of which disease?

1 Epidermolysis bullosa accquisita

2 Herpes gestationis

3 Pemphigus vulgaris

4 Pemphigus foliacious

5 Paraneoplastic pemphigus



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Circulating autoantibodies to type XVII collagen are most characteristic of which disease?

2 Herpes gestationis

Type XVII collagen or BPAG2 is a transmembrane protein found in the hemidesmosome.Autoantibodies to type XVII collagen are important in the pathogenesis of cicatricial pemphigoid,

bullous pemphigoid, and herpes gestationis.Q/Q(M)-476544 Report a Problem


1 Wrinkle-resistance : formaldehyde

2 Chewing gum : colophony

3 Parabens : artichokes

4 Glyceryl thioglycolate : acid permanent wave

5 Permethrin : chrysanthemum



3 Parabens : artichokes

Wrinkle-resistant clothing is treated with formaldehyde. Chewing gum contains rosin (colophony).Parabens are preservatives. Artichokes are a member of the family Asteraceae (formerly Compositae).Glyceryl thioglycolate and methylchloroisothiazolinone are found in acid permanent wave products.Permethrins are synthetic pyrethroids that are similar to pyrethrins derived from the Asteraceae family.Permethrins can cross-react with allergy to chrysanthemums.


Paraneoplastic pemphigus:

1 Is characterized by a pathognomonic 250 kDa antigen

2 Is most often seen in association with lung cancer

3 Does not remit even if the cancer is excised completely

4 May be caused by a benign neoplasm



Paraneoplastic pemphigus:

4 May be caused by a benign neoplasm

Paraneoplastic pemphigus can be caused by lymphoma as well as other malignancies. It can also besecondary to benign thymomas and Castleman's disease. Numerous antigens have been found, includingdesmoplakin I and II. Desmoplakin I and II may be antigenic in Stevens-Johnson syndrome.


Gallstones are associated with:


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1 Erythropoietic protoporphyria

2 Hepatoerythropoietic porphyria


4 Coproporphyria

5 HarderoporphyriaQ/Q(M)-474102 Report a Problem

Gallstones are associated with:

1 Erythropoietic protoporphyria

Gallstones and liver failure can complicate erythropoietic protoporphyria.Q/Q(M)-474102 Report a Problem

Ocular cicatricial pemphigoid has antibodies against:1 Gamma-catenin

2 Peripherin

3 Beta4-integrin

4 Kalinin

5 Vinculin


Ocular cicatricial pemphigoid has antibodies against:

3 Beta4-integrin

Ocular cicatricial pemphigoid (CP) has autoantibodies against beta4-integrin. CP associated withmalignancy has autoantibodies against epiligrin (laminin 5). CP with mucous membrane and skinfindings often has autoantibodies against BPAg2.


The most common malignancy associated with paraneoplastic pemphigus is:



3 Multiple myeloma

4 Acute myelocytic leukemia

5 Hodgkin's lymphoma


The most common malignancy associated with paraneoplastic pemphigus is:


Paraneoplastic pemphigus is associated with various benign as well as malignant internal tumors, withthe most common being non-Hodgkin's lymphoma.


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Which of the following is not a formaldehyde-releasing preservative?

1 Bronopol

2 Methylchloroisothiazinolone

3 Quaternium-15

4 Imidazolidinyl urea

5 DMDM hydantoin


Which of the following is not a formaldehyde-releasing preservative?

2 Methylchloroisothiazinolone

Methylchloroisothiazinolone, also known as Kathon CG, is the only non-formaldehyde releasing preservative. It is found in cosmetics, skin/hair products, "acid" permanent waves, soaps, latexemulsions, and biocides. All the others are formaldehyde-releasing preservatives.


Patients with Senear-Usher syndrome are most likely to present with:

1 Erythematous papules and plaques around the umbilicus

2 Transient vesicles on the oral mucosa

3 Severely pruritic grouped vesicles symmetrically distributed primarily on extensor surfaces

4 Erythema multiforme-like oral ulcerations which are severe5 Erythematous crusts and hyperkeratotic lesions on the nose, ears, cheeks, scalp, and chest


Patients with Senear-Usher syndrome are most likely to present with:

5 Erythematous crusts and hyperkeratotic lesions on the nose, ears, cheeks, scalp, and chest

Senear-Usher syndrome, also known as pemphigus erythematosus, is thought to be an overlap betweenlupus erythematosus and pemphigus foliaceous. The histology resembles that of pemphigus foliaceous

with linear IgG at the dermoepidermal junction. 80% of patiens have a positive lupus band.Q/Q(M)-474191 Report a Problem

The vector of fogo selvagem may be:

1 Triatoma

2 Simulium

3 Cimex

4 Ornithodorus

5 Mus



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The vector of fogo selvagem may be:

2 Simulium

Fogo selvagem is considered to be an endemic form of pemphigus foliaceus, first described in Brazil, inrural areas where Simulium (black fly) is often found. Subsequently, other rural South American areashave had clusters of affected patients.


Each of the following is true about anti-p200 pemphigoid except:

1 Responsive to dapsone

2 Subepidermal bullae

3 200-kd antigen

4 features of linear IgA disease

5 mucosal involvement


Each of the following is true about anti-p200 pemphigoid except:

5 mucosal involvement

Anti-p200 pemphigoid is an autoimmune blistering disorder. These autoantibodies bind to a 200-kDantigen found at the lamina lucida-lamina densa interface, thereby causing a subepidermal bullae.Clinical features of this disease are similar to bullous pemphigoid, dermatitis herpetiformis and linear

IgA disease. In the case reported by Egan, et.al., the patient responded well to steroids and dapsone anddid not have mucosal lesions.Q/Q(M)-477316 Report a Problem

A patient develops erythema and vesiculation on his dorsal foot that spares the toewebs and soles after buying a new pair of shoes. What is the most likely allergen?

1 Thiuram mix

2 Carbamates

3 Latex

4 Mercaptobenzothiazole5 Formaldehydge


A patient develops erythema and vesiculation on his dorsal foot that spares the toewebs and soles after buying a new pair of shoes. What is the most likely allergen?

4 Mercaptobenzothiazole

This patient has allergic shoe dermatitis. The number one cause is mercaptobenzothiazole, a rubber

accelerator. Other rubber accelerators include carbamates--found in bleached fabrics like waistbands andconsumer rubber products such as condoms, swimwear etc--and thiuram mix, found in almost all rubber.Of note thiuram is also present in antiscabies medication and the disulfiram.


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Patients with Duhring's disease are most likely to have:

1 Mutations in plectin

2 Mutations in laminin 5

3 Mutations in transglutaminase I

4 Antibodies to transglutaminase 3

5 Antibodies to BPAg2


Patients with Duhring's disease are most likely to have:

4 Antibodies to transglutaminase 3

Duhring's disease is also known as dermatitis herpetiformis. Antibodies are found to transglutaminase 3,and the direct immunofluorescent studies show granular IgA and C3 in the dermal papillae. Mutations in

plectin are found in EBS with muscular dystrophy. Mutations in laminin 5 are found in patients withJEB,Herlitz type. Mutations in transglutaminase I are found in pateints with lamellar ichthyosis and non

bullous congenital ichthyosiform erythroderma.Q/Q(M)-474188 Report a Problem

Common causes of drug-induced linear IgA:

1 Vancomycin

2 Penicillin

3 Cephalosporins

4 Captopril



Common causes of drug-induced linear IgA:


Linear IgA disease that is induced by drugs is most commonly secondary to vancomycin. Other

implicated drugs include other antibiotics and captopril.Q/Q(M)-474633 Report a Problem

Which association is incorrect?

1 Epidermolysis bullosa acquisita : inflammatory bowel disease

2 Dermatitis herpetiformis : small bowel lymphoma

3 Paraneoplastic pemphigus : Castlemans

4 Herpes gestationis : menopause

5 Porphyria cutanea tarda : hemochromatosisQ/Q(M)-474639 Report a Problem


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Which association is incorrect?

4 Herpes gestationis : menopause

Herpes gestationis is an immunoblistering disease of pregnancy. Unlike pruritic urticarial papules and plaques of pregnancy, it recurs with successive pregnancies. It is associated with Grave's disease andchoriocarcinoma.


The C-terminal domain of BPAg2 is targeted in:


2 Cicatricial pemphigoid

3 IgA pemphigus

4 Duhring s disease

5 Pemphigoid gestationis


The C-terminal domain of BPAg2 is targeted in:


The C-terminal domain of BPAg2 is targeted in cicatricial pemphigoid. The NC16A domain of BPAg2is targeted in bullous pemphigoid.


Patients with pemphigus vulgaris have lesions that start in the mouth in approximately :1 70% of patients

2 50% of patients

3 30% of patients

4 20% of patients

5 10% of patients


Patients with pemphigus vulgaris have lesions that start in the mouth in approximately :

1 70% of patients

In 70% of patients, pemphigus vulgaris starts in the mouth and other mucosal surfaces can also beinvolved.


You are consulted on this patient who has just undergone an orthopedic spinal procedure. What is true ofthis patient?

1 She should avoid bananas


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2 She is allergic to betadine

3 She is most likely having an allergic response to an antibiotic

4 She has miliaria crystallina

5 This is not related to her procedure


You are consulted on this patient who has just undergone an orthopedic spinal procedure. What is true ofthis patient?

1 She should avoid bananas

This patient had an allergic contact dermatitis to latex products used during the procedure. Latex cross-reacts with bananas, avocados, kiwis and chestnuts. The linear and geometric distribution is a clue to thediagnosis.


"Oriental" tiger balm cross-reacts with:

1 Balsam of Peru

2 Ylang-Ylang oil

3 Neomycin

4 Lanolin

5 Rosin


"Oriental" tiger balm cross-reacts with:

1 Balsam of Peru

"Oriental" tiger balm is a popular Chinese proprietary ointment used to relieve aches and pains. Patientswho develop allergic contact dermatitis to this agent have also been shown to have cross-reactions with

balsam of Peru. A similar substance known as "Bavarian" tiger balm has been reported to cross reactwith rosin.


Direct immunofluorescent studies in a patient with bullous pemphigoid is most likely to show:


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4 Herpes labialis

5 Rheumatoid arthritis


Which of the following is associated with dermatitis herpetiformis?

1 Gluten-sensitive enteropathy

Gluten-sensitive enteropathy or Celiac disease is demonstrated on small bowel biopsy of all patientswith dermatitis herpetiformis. However, most of these patients do not demonstrate symptoms ofgastrointestinal disease. Dermatitis herpetiformis (DH) is not associated with inflammatory boweldisease, autoimmune hepatitis, herpes labialis, or rheumatoid arthritis.


Epidermolysis bullosa simplex is caused by mutations in:

1 Keratins 1&10

2 Keratins 1&9

3 Keratins 5&14

4 Keratins 6a &16

5 Keratins K2e&10


Epidermolysis bullosa simplex is caused by mutations in:

3 Keratins 5&14

EB Simplex is caused by mutations in keratins 5 &14. Mutations in Keratins 1&10 are associated withepidermolytic hyperkeratosis ande Unna-thost. Mutations in keratins 1&9 are associated withepidermolytic palmoplantar keratoderma. Mutations in Keratins 6a and 16 are associated withPachyonychia congenital. Mutations in K2e and 10 are associated with Icthyosis bullosa of Siemens.


Which of the following is the most common cause of contact dermatitis due to a formaldehyde releasing preservative?

1 Paraben mix

2 Thimerosal

3 Quaternium 15

4 Imidazolidinyl urea

5 Paraphenylenediamine


Which of the following is the most common cause of contact dermatitis due to a formaldehyde releasing preservative?

3 Quaternium 15


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Quaternium 15 is the primary cause of contact dermatitis among formaldehy-releasing preservatives.Other formaldehyde-releasing preservatives include imidazolidinyl urea, diazolidinyl urea, DMDMhydantoin, Bronopol, Cyanobutane, Ethyleneurea melamine formaldehy resin (found in permanent pressclothing), and dimethylol dihydroxyethyleneurea. Paraben mix (#1 preservative in topicals), thimerosal(a type of mercurial antiseptic), and paraphenylenediamine (hair dye) are non-formaldehyde releasing

preservatives.


A 20-year-old female presents with an allergic contact dermatitis to a perfume containing Lily of thevalley. What is the causative allergen?

1 Cinnamic acid

2 Vanillin

3 Hydroxycitronellal

4 Atranorin

5 Evernic acidQ/Q(M)-482378 Report a Problem

A 20-year-old female presents with an allergic contact dermatitis to a perfume containing Lily of thevalley. What is the causative allergen?

3 Hydroxycitronellal

The main allergen in Lily of the valley, which is found in perfumes, soaps, cosmetics, eye cream andaftershaves, is hydroxycitronellal (synthetic). Cinnamic acid and vanillin are present in Balsam of Peru,while atranorin and evernic acid are allergens in oak moss absolute.


Cleavage of this adhesion molecule is seen in Staphylococcal Scalded Skin Syndrome:

1 Desmoplakin 1

2 Desmoplakin 2

3 Desmoglein 1

4 Desmoglein 3

5 Desmoplakin 1 and desmoplakin 2


Cleavage of this adhesion molecule is seen in Staphylococcal Scalded Skin Syndrome:

3 Desmoglein 1

Desmoglein 1 is cleaved by exfoliative toxin in Staphylococcal scalded skin syndrome.Q/Q(M)-474624 Report a Problem

This is associated with deafness:

1 Claudin2 Cadherin


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3 Connexin

4 Desmin

5 Desmoplakin


This is associated with deafness:

3 Connexin

Connexin 26 is associated with PPK and deafness. Mutations in this same connexin is associated withVohwinkel s and KID syndromes.


Which form of epidermolysis bullosa presents with generalized bullae, absent nails, dysplastic teeth (dueto enamel defects), nonhealing granulation tissue periorally, and is often fatal by age 3-4?

1 Weber-cockayne2 Herlitz

3 Non-Herlitz

4 Hyperplastic cockayne-touraine

5 Albapapuloid Pasini variant


Which form of epidermolysis bullosa presents with generalized bullae, absent nails, dysplastic teeth (due

to enamel defects), nonhealing granulation tissue periorally, and is often fatal by age 3-4?2 Herlitz

Junctional EB is an autosomal recessive disorder with a defect in the lamina lujcida; uncein is absent inall forms. The Herlitz variant is due to mutations in laminin 5 and clinically presents as generalized

bullae (which are non-scarring), nonhealing granulation tissue periorally, absent nails, dysplastic teethand enamel defects, anemia, growth retardation and is often fatal by age 3-4 due to low protein, anemiaand infection. The non-Herlitz variant of Junctional EB presents with bullae especially on theextremities which heal with atrophic scarring; pts improve with age and typically have a normal lifespan. Weber-cockayne is a type of EB simplex and presents with palmoplantar bullae and hyperhidrosis.Hyperplastic cockayne-touraine is a form of dominant dystrophic EB which presents with bullaelocalized to extremities. Albapapuloid Pasini variant of dystropohic EB presents with widespread bullae,atrophy, hypopigmented scar-like white papules on trunk, no miliaar or scarring, and mild oralinvolvement.


Which of the following can be responsible for contact dermatitis to K-Y Jelly?

1 Lanolin alcohol

2 Budesonide

3 Alpha tocopherol

4 Propylene glycol5 Triclosan


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Which of the following can be responsible for contact dermatitis to K-Y Jelly?

4 Propylene glycol

Propylene glycol is a widely used solvent and humectant found in a variety of products such ascosmetics, lotions, corticosteroids, antiperspirants, and K-Y jelly. Lanolin is an emollient which comesfrom wool wax and is found in adhesives, cosmetics, and topical emollients such as Aquaphor.Budesonide is a steroid, alpha tocopherol is topical Vitamin E, and Triclosan is a topical antibiotic.


Clumped tonofilaments are seen on electron microscopy in:

1 Dowling-Meara

2 Weber-Cockayne

3 Gunther s

4 Naxos disease

5 Vohwinkel s syndrome


Clumped tonofilaments are seen on electron microscopy in:

1 Dowling-Meara

Clumped tonofilaments (keratin intermediate filaments) are seen in EB simplex subtype Dowling-Meara. Weber-Cockayne is a subtype of EB simplex with trauma-induced blistering on the soles of thefeet and occasionally palms.

Q/Q(M)-474660 Report a Problem Bullous diabeticorum typically presents on the:

1 Face

2 Chest

3 Arms

4 Legs5 Groin


Bullous diabeticorum typically presents on the:

4 Legs

Bullous diabetocorum presents as tense blisters on the legs. They are typically non-inflammatory andappear suddenly.

Q/Q(M)-474596 Report a Problem The defect in junctional epidermolysis bullosa occurs at the:


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1 Granular layer

2 Spinous layer

3 Lamina lucida

4 Lamina densa

5 Sublamina densaQ/Q(M)-474605 Report a Problem

The defect in junctional epidermolysis bullosa occurs at the:

3 Lamina lucida

Junctional epidermolysis bullosa is an autosomal recessive disorder characterized by a defect in thelamina lucida. The protein uncein, a molecule which binds the gamma chain of laminin anda6b4/BPAg1, is absent in all forms of junctional EB. Uncein is normally found in the lamina lucida,along with lamin 1, laminin 5, laminin 6m, heparan sulfate proteoglycan, and fibronectin.


Epidermolysis bullosa simplex with muscular dystrophy is associated with a mutation in:

1 Laminin 5

2 Plectin

3 collagen VII

4 uncein

5 alpha 6 beta integrinQ/Q(M)-474484 Report a Problem

Epidermolysis bullosa simplex with muscular dystrophy is associated with a mutation in:

2 Plectin

EB Simplex is an autosomal dominant disorder caused by mutations in keratins 5 &14, leading tointraepidermal bullae. A subtype of EBS patients have muscular dystrophy due to a defect in plectin.Laminin 5 mutations are associated with junctional EB. Collagen VII mutations are associated withdystrophic EB. Uncein is a protein in the lamina lucida which is found to be absent in junctional EB.Mutations in alpha6-beta4 integrins are associated with JEB with pyloric atresia.



1 Eyedrops : thimerosal

2 Ear drops : neomycin

3 Theophylline : ethylenediamine

4 Antabuse : thiuram

5 Cobalamin : balsam



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5 Cobalamin : balsam

Cobalamin is Vitamin B12; cobalt is a component of Vitamin B12. Balsam of Peru is found infragrances.


Herpes gestationis is most commonly associated with:

1 Grave's

2 Hashimoto's

3 Diabetes

4 Lupus

5 Rheumatoid arthritis


Herpes gestationis is most commonly associated with:

1 Grave's

Autoimmune diseases are associated with herpes gestationis; Grave's disease is the most commonassociation.


What is the antigen associated with dermatitis herpetiformis?

1 Tissue transglutaminase

2 Epilegrin

3 Desmocollin

4 Desmoglein 3

5 Periplakin


What is the antigen associated with dermatitis herpetiformis?

1 Tissue transglutaminase

Dermatitis herpetiformis is an autoimmune blistering disease associated with intense pruritus.Classically, it involves the extensor aspects of the body. Antibodies to tissue transglutaminase (anti-endomesial, anti-gliadin, anti-reticulin) can be found. It is associated with celiac sprue. 50% havethyroid disease.


Gap junctions consist of:

1 Laminin

2 Plectin3 Uncein


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3 Erythema toxicum neanotorum

Papule and pustules on an erythematous base appear on a healthy infant within 48 hours, and typicallylast 2-3 days in erythema toxicum neanotorum. The lesions may occur anywhere, but usually spare the

palms and soles. Gram stain reveals numerous eosinophils. A 1 day-old infant would not have had achance to acquire a scabies infestation. Acropustulosis of infancy typically presents at 3-4 months andthe pathology shows vesicles with many neutrophils. A herpes infection would not show eosinophils.Transient neonatal pustular melanosis shows sterile sub corneal pustules.


Which of the following adhesion molecules are important for maintaining adhesion betweenkeratinocytes?

1 Selectins

2 Integrins

3 Cadherins

4 Glycans

5 Immunoglobulin superfamily


Which of the following adhesion molecules are important for maintaining adhesion betweenkeratinocytes?

3 Cadherins

Cadherins mediate cell adhesion and play a fundamental role in normal development. Calicum isrequired for the normal function of these adhesion molecules. There are two main subclasses, classic (E-, P-, N-) and desmosomal (desmoglein and desmocollin).


Which of the following is true of a phototoxic reaction?

1 Requires prior sensitization of photoallergen in susceptible individuals

2 Photoallergen must bind to carrier protein

3 Develops after repeated exposures

4 Produces an eczematous reaction

5 Results in direct tissue injury


Which of the following is true of a phototoxic reaction?

5 Results in direct tissue injury

Phototoxic reactions result in direct tissue injury when the phototoxic agent interacts with light energy toform reactive oxygen species. It is characterized by an eruption similar to a sunburn.


This medicine causes degranulation of mast cells


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1 NSAIDs

2 ASA

3 opiates

4 polymixin B

5 All of these answers are correctQ/Q(M)-474099 Report a Problem

This medicine causes degranulation of mast cells


Mast cell degranulators include NSAIDs, ASA, opiates, polymixin B, radiocontrast, tubocurarine,succinylcholine, and others.


Herpes gestationis is most commonly associated with:1 Lymphoma

2 Multiparity

3 Grave's disease

4 Inflammatory bowel disease

5 Lupus


Herpes gestationis is most commonly associated with:3 Grave's disease

Herpes gestationis (HG) typically occurs in the second or third trimester, and clinically presents asurticarial papules and plaques around the umbilicus which progress to involve the rest of the body. HGhas been associated with Grave's disease.


Direct immunofluorescent studies in chronic bullous disease of childhood is most likely to show:

1 Iga depostion in the superficial blood vessels

2 Linear IgG at the basement membrane3 Linear IgA at the basement membrane

4 Granular IgG

5 Linear C3 at the basement membrane


Direct immunofluorescent studies in chronic bullous disease of childhood is most likely to show:

3 Linear IgA at the basement membrane

Chronic bullouse disease of childhood is believed to be a variant of linear IgA bullous disease, sincedisease are characterized by antibodies to the 97kDa antigen that is a part of BPAg2. Children presentwith extremely pruritic blisters in circular arrangements. Pathology shows a subepidermal bullae with


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neutrophils at the dermo-epidermal junction; the DIF shows IgA deposition at the basement membranein a linear fashionl.


In staphylococcal scalded skin syndrome, the exfoliative toxin cleaves:

1 Desmoglein 1

2 Desmoglein 3

3 Desmocollin 1

4 Desmocollin 3

5 BpAg2


In staphylococcal scalded skin syndrome, the exfoliative toxin cleaves:

1 Desmoglein 1

Staphylococcal scalded skin syndrome is caused by Staphylococci group 2, phage typ 71, which produces an exofliative toxin that cleaves desmoglein 1. Clinically, this results in a subcornealseparation of keratinocytes, leading to skin tenderness, erythema, and superficial desquamatioin of skin.


Common cause(s) of drug-induced pemphigus foliaceus:

1 Captopril

2 Penicillamine

3 Captopril and penicillamine4 Methotrexate

5 Dilantin


Common cause(s) of drug-induced pemphigus foliaceus:

3 Captopril and penicillamine

Penicillamine and captopril are common causes of drug-induced pemphigus.


IgA pemphigus is a pustular acantholytic dermatosis with intracellular IgA deposition. The mostcommon target on keratinocytes with patients with IgA pemphigus is:

1 Desmocollin1

2 Dsg2

3 IgG

4 C35 IgM


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2 Dapsone

3 Colchicine

4 Prednisone

5 IVIG


The best first line treatment for dermatitis herpetiformis is:

2 Dapsone

The most effective drug for dermatitis herpetiformis is dapsonel. The dose varies between 50 and 300mgdaily. Side effects include hemolytic anemia, leukopenia, methemoglobinemia, and rarelyagranulocytosis or peripheral neuropathy. Sulfapyridine is also a very effective treatment for dermatitisherpetiformis.


Antibodies to which antigen are most likely responsible for this disease?

1 Bullous pemphigoid antigen II

2 Desmoglein I

3 Desmocollin

4 Keratin 5

5 Plakoglobin


Antibodies to which antigen are most likely responsible for this disease?

1 Bullous pemphigoid antigen II

The clinical appearance of tense bullae and urticarial plaques is suggestive of bullous pemphigoid.Bullous pemphigoid antigen II is a transmembrane protein in the hemidesmosome. Antibodies to thisantigen are pathogenic in bullous pemphigoid.


The most important group of disease linked with the pathogenesis of paraneoplastic pemphigus in adultsis


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1 Lymphoproliferative disorders

2 Colerectal adenocarcinoma

3 Breast Cancer

4 Sarcomas

5 MelanomaQ/Q(M)-478692 Report a Problem

The most important group of disease linked with the pathogenesis of paraneoplastic pemphigus in adultsis

1 Lymphoproliferative disorders

The most important group of disease linked witht eh pathogenesis of pareneoplastic pemphigus isLymphoproliferative disorders. Most commonly non-Hodgkin's lymphoma, CLL, Castleman's tumor,sarcoma, and thymoma.


Which of the following agent(s) has been most effective in treating severe ocular cicatricial pemphigoid?

1 Cyclophosphamide

2 Mycophenolate mofetil

3 Cyclophosphamide + corticosteroids

4 Cyclosporin

5 Azathioprine


Which of the following agent(s) has been most effective in treating severe ocular cicatricial pemphigoid?

3 Cyclophosphamide + corticosteroids

Cicatricial pemphigoid is a heterogeneous group of subepithelial blistering diseases involving themucous membranes and skin. The treatment of cictracial pemphigoid is predicated upon the extent,severity, and location of disease. Most regimens used are empiric and are based on clinical experience.With severe ocular involvement, most experts recommend aggressive treatment with the combination ofcyclophosphamide and steroids.


Patients with epidermolysis bullosa acquisita have:

1 A defect in plectin

2 A defect in collagen XVII

3 Antibodies to collagen XVII

4 Antibodies to collagen VII

5 A defect in laminin 5



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Patients with epidermolysis bullosa acquisita have:

4 Antibodies to collagen VII

Epidermolysis bullosa acquisita (EBA) classically presents in adulthood as noninflammatory trauma-induced bullae that heal with scarring, especially on the hands and feet. Histology shows a subepidermal

blister (usually pauci-inflammatory); DIF shows linear IgG at the basememt membrane; salt-split skinshows antibodies at the "floor". Patients hae antibodies to type VII collagen.


This is derived from Myroxylon pereirae:

1 Thimerosol

2 Aniline dyes

3 Balsam of Peru

4 Colophony

5 Thiuram


This is derived from Myroxylon pereirae:

3 Balsam of Peru

Balsam of Peru is derived from the Myroxylon pereriae tree. Thimerosal is a questionable cause ofallergic contact dermatitis; it is found in vaccines and contact lens solutions.


Which of the following forms of epidermolysis bullosa is autosomal recessive?

1 Weber-Cockayne

2 Dowling-Meara

3 Junctional EB with pyloric atresia

4 EB simplex with muscular dystrophy

5 Hyperplastic cockayne-touraine


Which of the following forms of epidermolysis bullosa is autosomal recessive?

3 Junctional EB with pyloric atresia

The forms of junctional epidermolysis bullosa are inherited in an autosomal recessive fashion. Theseinclude Herlitz, non-Herlitz, JEB with pyloric atresia, JEB inversa, and GABEB. Recessive dystrophicEB (Hallopeau-Siemens) is also a recessive subtype of dystrophic EB. EB simplex is typically inheritedin an autosomal dominant fashion. Hyperplastic cockayne-touraine is a subtype of dominant dystrophicEB.


Etyhlenediamine dihydrochloride is known to cross-react with all the following substances except?1 Neomycin


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2 Aminophylline

3 Promethazine

4 Meclizine

5 Hydroxyzine


Etyhlenediamine dihydrochloride is known to cross-react with all the following substances except?

1 Neomycin

Ethylenediamine dihydrochloride is a stabilizer found in aminophylline, theophylline, antihistaminecreams, and Mycolog cream (nystatin/triamcinolone). It is also used in synthetic coolants, rubberaccelerators, insecticides, and fungicides. It is not known to cross react with neomycin.


Formaldehyde releasers include all except:1 Methylchoroisothiazolinone

2 Germall

3 Quaternium 15

4 Dowicil

5 DMDM hydantoin


Formaldehyde releasers include all except:1 Methylchoroisothiazolinone

Methylchloroisothiazolinone is also known as Kathon CG and it is a preservative. Germall, quaternium15 (dowicil 200), DMDM hydantoin, and others are formaldehyde-releasing preservatives.


An elderly gentleman with a history of hypertension and a thymoma, presents to the Emergency Roomwith oral and conjunctival erosions and hemorrhagic bullae on his hands and feet. These finds are seenin:

1 Cicatricial pemphigoid2 Sweets syndrome

3 Toxic epidermal necrolysis


5 Erythema multiforme


An elderly gentleman with a history of hypertension and a thymoma, presents to the Emergency Roomwith oral and conjunctival erosions and hemorrhagic bullae on his hands and feet. These finds are seenin:



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Paraneoplastic pemphigus is usually associated with cancers of lymphoid origin, including lymphoma,leukemia, thymomas, Castleman s tumor. Clinically, this condition may present with intractablestaomatitis, severe painful oral and conjunctival erosions.


Which of the following is known as "prickly heat"?

1 Miliaria crystallina

2 Miliaria rubra

3 Miliaria profunda

4 Grover's disease

5 Fox-Fordyce disease


Which of the following is known as "prickly heat"?

2 Miliaria rubra

Miliaria are caused by occusion of ecrine sweat glands. Miliaria crystalina are clear minute subcornealvesicles with no inflammation. Miliaria rubra are red papules subepidermal vesicles with inflammation.Miliaria rubra is known as "prickly heat" as it presents after sweating, heat exposure, fever or occlusion.Miliaria profunda or pustulosa are red nodules or pustules with deeper inflammation. Fox-Fordycedisease is apocrine miliaria that is very pruritic and presents in axilla and anogenital area of women.Grover's disease is a papulovesicular eruption of the trunk that is pruritic and can occur after sunexposure or in bedridden patients with occluded backs. Histologically Grover's disease presents withsmall foci of acantholytic dyskeratotic cells in the suprabasal region.


What is the antigen found in the variant of cicatrical pemphigoid that is associated with internalmalignancies?

1 BPAg1

2 BPAg2

3 Type VII collagen

4 Epiligrin

5 Keratins 5 & 14


What is the antigen found in the variant of cicatrical pemphigoid that is associated with internalmalignancies?

4 Epiligrin

Individuals with anti-epiligrin cicatricial pemphigoid are thought to be at an increased risk for solidinternal malignancies.


Nickel can be detected in jewelry by applying:


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1 Dimethylglyoxime

2 Methylchloroisothiazolinone

3 Dowicil

4 Quinone

5 ThiocyanateQ/Q(M)-474656 Report a Problem

Nickel can be detected in jewelry by applying:

1 Dimethylglyoxime

Dimethylglyoxime application to metals containing nickel will show a pink color.Methylchloroisothiazolinone is Kathon CG, a preservative. Dowicil is a formaldehyde-releasing

preservative. Primin is a type of quinone, and it is the allergen in primrose (Primula obconica).Thiocyanates are the irritating substances in garlic.


Perioral exuberant granulation tissue is sometimes seen in:


2 Herlitz

3 Duhring's

4 Weber-Cockayne

5 Stevens-Johnson

Q/Q(M)-474628 Report a Problem Perioral exuberant granulation tissue is sometimes seen in:

2 Herlitz

The Herlitz form of junctional EB sometimes presents with excessive granulation tissue periorally, inthe axillary/neck area.


Which type of epidermolysis bullosa has the greatest risk of developing squamous cell carcinomas?

1 Weber-Cockayne

2 Dowling-Meara

3 Herlitz

4 EB Simplex with muscular dystrophy

5 Hallopeau-Siemens type of recessive dystrophic EB


Which type of epidermolysis bullosa has the greatest risk of developing squamous cell carcinomas?5 Hallopeau-Siemens type of recessive dystrophic EB


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Dystrophic EB is due to a defectin collagen 7, leading to decreased or absent anchoring fibrils in thesublamina densa. The three types of dominant dystrophic EB include Hyperplastic cockayne-Touraine,Albopapuloid Pasini, and Bart's. The Recessive form of dystrophic EB is also known as HallpeauSiemens and patients present at birth owith generalized bullae which lead to erosions and atrophicscarring, mitten deformities, flexion contractures, oral and esophageal scarring and strictures anddysplastic teeth. There is an increased risk of squamous cell carcinomas.

Q/Q(M)-474589 Report a Problem Herpes gestationis is exacerbated by:

1 Oral contraceptives

2 Menstruation

3 Third trimester

4 Postpartum state



Herpes gestationis is exacerbated by:


Herpes gestationis has also been associated with choriocarcinoma in several case reports.Q/Q(M)-474634 Report a Problem

Which of the following immunosuppressive agents has been most effective in cicatricial pemphigoid?

1 Cyclophosphamide

2 Azathioprine3 Mycophenolate mofetil

4 Cyclosporine

5 Methotrexate


Which of the following immunosuppressive agents has been most effective in cicatricial pemphigoid?

1 Cyclophosphamide

Cicatricial pemphigoid is a heterogeneous group of subepithelial blistering diseases involving themucous membranes and skin. The treatment of cictracial pemphigoid is predicated upon the extent,severity, and location of disease. Most regimens used are empiric and are based on clinical experience.With severe ocular involvement, most experts recommend aggressive treatment with the combination ofcyclophosphamide and steroids.


A patients with a history of leukemia that had severe, persistent painful stomatitis extending from thelips into the pharynx, larynx and esophagus. Conjunctival involvement may lead to blindness. Thecutaneous changes are polymorphic, ranging from erythematous macules to lichenoid papules to blisters

and erosions. This patient most likely has:


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2 Erythema multiforme


4 Chemotherapy induced stomatitis

5 Persistent herpes simplexQ/Q(M)-482898 Report a Problem

A patients with a history of leukemia that had severe, persistent painful stomatitis extending from thelips into the pharynx, larynx and esophagus. Conjunctival involvement may lead to blindness. Thecutaneous changes are polymorphic, ranging from erythematous macules to lichenoid papules to blistersand erosions. This patient most likely has:


This patient has paraneoplastic pemphigus. It is an uncommon blistering disease with a variety ofclinical patterns and target antigens associated with underlying malignancy. It is most likely associatedwith lymphoma, leukemia, Castleman tumor, or thymoma. Diagnosis is by indirect immunofluorescenceis positive on rat bladder epithelium.


Antibodies in chronic disease of childhood disease, map to the:

1 Basal layer

2 Lamina lucida

3 Lamina densa

4 Sublamina densa5 Lamina lucida and sublamina densa

Q/Q(M)-474075 Report a Problem Antibodies in chronic disease of childhood disease, map to the:

5 Lamina lucida and sublamina densa

Immunoelectron mapping of chronic disease of childhood has shown binding within the lamina lucida aswell as in the sublamina densa. This correlates with the finding of the 97-kDa antigen that ishomologous to a portion of the BPAg2 molecule as well as a 280-290 kDa antigen in this disease. Somehave suggested that the 280-290 kDa antigen is type VII collagen, but the former does not co-migratewith type VII collagen on Western blots.


Dermatitis herpetiformis is associated with:

1 HLA-Cw6

2 HLA-B27

3 HLA-DR4

4 HLA-DQ15 HLA-DR3


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Dermatitis herpetiformis is associated with:

5 HLA-DR3

HLA DR3 and DQ2 are associated with dermatitis herpetiformis. HLA B27 is associated with psoriasis

with spondylarthropathy, while HLA Cw6 is associated with psoriasis.Q/Q(M)-474642 Report a Problem

Which steriod screening agent should be used when an allergic contact dermaititis is suspected tohydrocortisone?

1 Glutaral

2 Tixocortol-21-pivalate

3 Budesonide

4 Hydrocortisone-17-butyrate

5 Benzalkonium chloride


Which steriod screening agent should be used when an allergic contact dermaititis is suspected tohydrocortisone?

2 Tixocortol-21-pivalate

Tixocortol-21-pivalate is a group A steroid and screens for allergies to hydrocortisone, prednisone, andmethylprednisolone. Budesonide screens for groups B and D steroids, and hydrocortisone-17-butyrate

screens for group D steroids.Q/Q(M)-476780 Report a Problem

Fecal isocoproporphyrin is seen in:

1 Porphyria cutanea tarda

2 Harderoporphyria


4 Acute intermittent porphyria

5 CoproporphyriaQ/Q(M)-473655 Report a Problem

Fecal isocoproporphyrin is seen in:

1 Porphyria cutanea tarda

Fecal isocoproporhyrin is characteristic of porphyria cutanea tarda.Q/Q(M)-473655 Report a Problem

The Absoe-Hansen sign as applies to blister formation refers to

1 Lateral slipping of the epidermis when perilesional is rubbed2 Lateral dissection of the blister when pressure is applied directly to a blister


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3 Blister formation following stroking of the lesion

4 Blister induction with incised trauma to skin

5 Blister formation after cryosurgery


The Absoe-Hansen sign as applies to blister formation refers to

2 Lateral dissection of the blister when pressure is applied directly to a blister

The Asboe-Hansen sign as applies to blister formation refers to lateral dissection of the blister when pressure is applied directly to the blister. This is also called, "bulla-spread phenomenon", because pressure on an inact bulla, genlty forces fluid to wander under the skin away from the pressure site.


What is the most common cause of this entity?

1 Drugs2 Infections

3 Malignancies

4 Idiopathic

5 UV exposure


What is the most common cause of this entity?

1 Drugs

Stevens-Johnson syndrome (SJS) is an immune-complex- mediated hypersensitivity complex that is asevere expression of erythema multiforme. Most authors and experts consider SJS and toxic epidermalnecrolysis (TEN) different manifestations of the same disease. The most common cause of recurrentepisodes are erythema multiforme (AKA herpes associated erythema multiforme (HAEM)), whereasdrugs are the most common cause of SJS/TEN.


An older patient with erythema and crusting in a butterfly distribution and seborrheic areas with erosionsis diagnosed with pemphigus erythematosus. The other synonym for pemphigus erythematosus is:

1 Senear-Usher syndrome2 Wildfire pemphigus


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3 Fogo Selvagem

4 Acrokeratosis verruciformis Hopf

5 Foliaceus erythematosus

Q/Q(M)-482896 Report a Problem An older patient with erythema and crusting in a butterfly distribution and seborrheic areas with erosionsis diagnosed with pemphigus erythematosus. The other synonym for pemphigus erythematosus is:

1 Senear-Usher syndrome

Pemphigus erythematosus is also known as Senear-Usher syndrome. It is an uncommon variant of pemphigus foliaceus with additional features of lupus erythematosus. It is most likely triggered bysunlight or medications than other forms of pemphigus foliaceus.


Which is incorrect?

1 Tulipalin : alstroemeria2 Urushiol : anacardia

3 Sesquiterpene lactones : artichokes

4 Usnic acid : lichen

5 Diallyl disulfide : fig


Which is incorrect?

5 Diallyl disulfide : fig

Tulipalin A is a byproduct of tuliposide A metabolism, and it is the allergen in alstroemeria, thePeruvian lily, and tulips. Urushiol is the allergen in Toxicodendron plants as well as several other cross-reactors including cashew nut shells (Anacardium occidentale). Artichokes are in the family Asteraceae(formerly Compositae); this family is allergenic secondary to sesquiterpene lactones. Lichens containusnic acid. The fig tree is in the family Moraceae, which is one of the plant families that can cause

phytophotodermatitis.Q/Q(M)-474653 Report a Problem

Atopic dermatitis is associated with all except:1 Lchthyosis hystrix

2 Central facial pallor

3 Pityriasis alba

4 Nipple eczema

5 Hyperlinear palms

Q/Q(M)-474625 Report a Proble

vesicular and bullous dermatosis mcqs

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