Pigmentary disorders: Riehl melanosis: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Pigmentary disorders: Riehl melanosis

Sample item

A woman using a fragrance-containing facial cream develops slowly progressive, reticulated grey-brown pigmentation on the forehead and temples, with minimal itching. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Riehl melanosis (pigmented contact dermatitis)

Riehl melanosis is a pigmented contact dermatitis from cosmetic allergens such as fragrances and dyes, producing grey-brown reticulate pigmentation on the face. Patch testing identifies the allergen and avoidance with photoprotection is the main treatment. It is common in skin of colour.

Option by option

  • A. Naevus of Ota

    Naevus of Ota is unilateral blue-brown in V1 and V2.

  • B. Riehl melanosis (pigmented contact dermatitis) (correct)

    Correct. Riehl melanosis follows cosmetic contact sensitisation.

  • C. Acanthosis nigricans

    Acanthosis nigricans is velvety pigmentation in flexures.

  • D. Melasma of pregnancy

    Melasma has a symmetrical centrofacial pattern without cosmetic trigger.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is B, Riehl melanosis (pigmented contact dermatitis). Riehl melanosis is a pigmented contact dermatitis from cosmetic allergens such as fragrances and dyes, producing grey-brown reticulate pigmentation on the face.

Why is "Naevus of Ota" not the answer?

Naevus of Ota is unilateral blue-brown in V1 and V2.

Why is "Acanthosis nigricans" not the answer?

Acanthosis nigricans is velvety pigmentation in flexures.

Why is "Melasma of pregnancy" not the answer?

Melasma has a symmetrical centrofacial pattern without cosmetic trigger.

What concept does this question test?

It tests Pigmentary disorders: Riehl melanosis in Dermatology. Patch testing identifies the allergen and avoidance with photoprotection is the main treatment. It is common in skin of colour.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pigmentary disorders: Riehl melanosis?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.