DERMOTOLOGIST:
1)Which of the following statement is false with regard to Favus:
a.It is a form Tinea capitis
b.It is caused by Tinea schoenlein
c.It causes Cicatricial alopecia
d.It is characterised by presence of dark brown to black nodules cemented to the hair shaft
Solution:
Yellowish cup shaped crests known as scutula are characteristic of Favus
Dark brown/black nodules are observed in black piedra resulting from piedraia hortea.
Ref:Rook’s textbook of dermatology ,8th edition,page 36.15,36.27.
2).A woman aged 35years consulted a dermatologist owing to a persistent facila rash
Physical investigation disclosed an erythematous rash,without bilistering or ulceration,involving both cheeks and the nose
The nasolabial folds are relatively spared. The dermatologist also observes scattered erythematous,firm,maculopapular lesion
elsewhere on the woman’s face and on exposed areas fo the neck ,upper chest ,and elbows.
Careful investigation of the scalp reveals a few areas of focal alopecia.
On interrogation the woman states that she has had the rash more or less continuously for about six months and that it gets
much worse when she is exposed to sunlight
Which among the following autommune disease would most probably produce this patient skin problems:
a.Dermatomyositis
b.Progressive systemic sclerosis
c.Rheumatiod arthritis
d.Systemic iupus erythematosus
Solution:
Systemic lupus erythematosus refers to a systemic autoimmune disorder which is characterized by damage of tissues
and cells cased by pathogenic autoantibodies (Particularly antinuclear antibodies )and immune complexes.
seizures
characeristic skin rashes
Arthritis
Anemia
Psychiatric illness
The rash involving the nose and cheeks is the characteristic mala butterfly rash of SLE
Significant characteristics include:
Sparing of the nasolabial folds
Exacerbation with sunlight exposure
The rash distribution
Fixed erythema
The rash is not the only cutaneous manifestation of lupus. Alopecia and Maculopapular rash described in the case
may also be observed.
The characteristic of the rash of dermatomyositis is a lilac or heliotrope discoloration of the upper eyelieds accompanied
by periorbital edema.
Progressive systemic sclerosis or scleroderma leads to thick ,dense skin secondary to dermal fibrosis.
Rheumatoid arthritis characteristically leads to subcutaneous rheumatoid nodules.
Ref:Costner M.I.,Sontheimer R.D 2012. Chapter 155 lupus erythematosus. In L.A . Goldsmith,S.I .Katz, B.A.Gilchrest, A.S.
Paller, D.J.Leffell, N.A.Dallas eds , Fitzpatrick’s dermatology in General Medicine.8e.