Connective Tissue Disorders MCQs

Epidermal naevi Keratinocytic/hyperkeratotic/verrucous epidermal naevus Inflammatory linear verrucous epidermal naevus (ILVEN) Sebaceous naevus Pigment cell naevi Congenital melanocytic naevus Congenital blue naevus Congenital naevus spilus Congenital Spitz naevus Mongolian blue spot (dermal melanocytosis) Connective tissue naevi - Shagreen patch Muscle naevi Congenital smooth muscle hamartoma Leiomyoma Fat naevi - Congenital lipoma unclassifiable naevi - Becker naevus Reference: Rooks textbook of dermatology, 9 th edition, chapter 75, page 2

Sites of morphea: Upper trunk (MC), buttocks & legs Linear lesions on extremities & fate (en coupe sabre) Reference: Rook's textbook of dermatology, 9 th Edition, Chapter 57, Page 11

Clinical Features of Dermatomyositis Itchy lesion Facial lesion's: Heliotrope erythema, malar erythema, oedema Gottron's papule: Violaceous, atrophic papules over knuckles and pressure points Gottron's sign: Symmetrical, somewhat linear, lilac papulosquamous plaques Telangiectasia and ragged cuticles Poikiloderma: Hyperpigmentation, hypo pigmentation, telangiectasia and atrophy Mechanic's hand: Confluent symmetric hyperkeratosis along ulnar aspect of thumb and radial aspect of fingers Calcinosis cutis Shawl sign: Symmetrical confluent violaceous erythema extending from dorsolateral aspect of forearms and arms to deltoid region, shoulder and neck Reference: Rook's textbook of dermatology, 9 th Edition, Chapter 53, Page 6

Dermis forms a major part of the skin and is highly vascular, primarily consisting of the extracellular matrix of connective tissue. Type I collagen is the predominant type of collagen present in the dermis, approximately 80% of the total collagen Reference: Rooks textbook of dermatology 9 th edition, chapter 2, page 27

General measures, such as sun avoidance, avoidance of photosensitizing medications, and liberal application of sunscreen. Current first-line treatment for DLE consists of photoprotection in conjunction with topical or intralesional corticosteroids and topical calcineurin inhibitors. Antimalarials Hydroxychloroquine (HCQ)- are considered first-line systemic therapy for CLE. Reference: Rook's textbook of dermatology, 9 th Edition, Chapter 51, Page 3

subacute cutaneous lupus erythematosus is a subtype of LE presenting as symmetric, non-scarring photosensitive erythematous rash usually over sun-exposed areas like face, neck, arms, upper back, and shoulders. The systemic lupus erythematosus lesions have a characteristic distribution with either papulosquamous lesions or annular lesions with central clearing. Patients with SCLE frequently have a mild illness with musculoskeletal complaints and serologic abnormalities. Laboratory studies 0 anti-SSA/Ro and anti-SSB/La Reference: Rook's textbook of dermatology, 9 th Edition, Chapter 51, Page 11

Carpet tack sign is a characteristic sign of DLE. It is also known as "cat's tongue sign" or "tin tack sign" It occurs due to the accumulation of scales in the hair follicles with resultant loss of hair. Later on, when scales are peeled off, typical keratotic spikes become visible producing characteristic "carpet-tack sign". Reference: Rook's textbook of dermatology, 9 th Edition, Chapter 51, Page 3

In the patient - violaceous macular erythema is noted in the periorbital area - Heliotrope rash difficulty in climbing stairs and combing hair - s/o proximal myopathy Together - diagnosis is Dermatomyositis Myositis (Weakness of proximal muscles), Difficulty in speech and swallowing, Cardiomyopathy, Reynaud's phenomenon, Arthralgia Reference: Rook's textbook of dermatology, 9 th Edition, Chapter 53, Page 6