Papulosquamous Disorders MCQs

Genital HPV remains the most common sexually transmitted pathogen in the United States, infecting 60% of a cohort of initially HPV-negative, sexually active Washington state college women within 5 years in a study conducted from 1990 to 2000-i.e., during the pre-HPV immunization era. Reference: Harrison's Principles of Internal Medicine, 21 st ed, Ch: 136, Pg: 1079

Most common cause of urethritis in males is N. gonorrhoea. The most common cause of Non-Gonococcal urethritis in males is Chlamydia trachomatis. The most common cause of urethritis in females is Chlamydia. Hence chlamydia is the most appropriate answer. Reference: Harrison's Principles of Internal Medicine, 21 st Ed, Ch:136 Pg: 1081, 1083

Ans. D. Lichen planus LP is characterized by shiny, violaceous, flat-topped polygonal papules which retain the skin lines. White lines, known as Wickham's striae, may traverse the surface of the papules. Linear lesions often appear along scratch marks or in scars (Koebner phenomenon). In most cases, the papules eventually flatten after a 6 months to 2 yrs, often to be replaced by an area of hyperpigmentation.

Four disorders of apocrine glands need to be remembered Apocrine bromhidrosis - excessive foul smelling body odor Apocrine chromhidrosis - secretion of colored apocrine sweat Fox - Fordyce disease Hidradenitis suppurativa Reference: Rook’s Textbook of Dermatology, 9th Edition, Chapter 94, Page 15

Oral Lesion of Lichen Planus White, reticulate lacy pattern on the buccal mucosa, tongue and gingival Asymptomatic - Reticular OLP complain of intolerance to spicy food - Erosive OLP Reference: Rooks textbook of dermatology, 9 th edition, chapter 37, page 5

"Pruritic, Purple, Polygonal, Planar, Papules "are the traditional 5 "P's" of LP Reference: Rooks textbook of dermatology, 9 th edition, chapter 37, page 3

Histopathology in Lichen planus The basic pathology in lichen planus is the damage to the basal cell layer of epidermis leading to degeneration of basal cells. Epidermal thickening especially of granular cell layer → Hypergranulosis. Hyperkeratosis (Thickening of stratum corneum) Acanthosis (Thickening of Stratum) malpighii. Subepidermal - lichenoid band due to deposition of lymphocytes & histiocytes in upper dermis. Dropping of melanin pigment from damaged keratinocytes of epidermis into dermis → pigment incontinence. This melanin is engulfed by macrophages which results information of cytoid bodies (civatte or colloid bodies). Max Joseph Histological cleft → Separation of epidermis in small clefts. Reference: Rooks textbook of dermatology, 9 th edition, chapter 37, page 14

The hallmark of lichen nitidus is a well-circumscribed granulomatous infiltrate of lymphocytes, macrophages, Langerhans giant cells, and multinucleated epithelioid histiocytes in the papillary dermis bordered by extensions of epidermal ridges. This sharply circumscribed inflammatory infiltrate generally spans 4 to 5 dermal papillae within the dermis, giving a "ball-in-clutch" configuration Reference: Rooks textbook of dermatology, 9 th edition, chapter 37, page 10