Metabolic skin signs: lichen amyloidosis: 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 · Metabolic skin signs: lichen amyloidosis

Sample item

A 40-year-old man has intensely itchy, hyperkeratotic, rippled brown papules on the shins. Biopsy shows apple-green birefringence with Congo red under polarised light in the papillary dermis. What is the diagnosis?

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

The answer and the reasoning

C. Lichen amyloidosis

Lichen amyloidosis is a form of primary localised cutaneous amyloidosis with pruritic, rippled keratotic papules on the shins, with keratin-derived amyloid deposits in the papillary dermis. Chronic scratching is the driver. Treatment is potent steroids and breaking the itch-scratch cycle.

Option by option

  • A. Prurigo nodularis

    Prurigo nodularis shows nodules without amyloid.

  • B. Hypertrophic lichen planus

    Hypertrophic lichen planus lacks amyloid.

  • C. Lichen amyloidosis (correct)

    Correct. Amyloid in the papillary dermis confirms lichen amyloidosis.

  • D. Lichen simplex chronicus

    Lichen simplex chronicus lacks amyloid on biopsy.

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 C, Lichen amyloidosis. Lichen amyloidosis is a form of primary localised cutaneous amyloidosis with pruritic, rippled keratotic papules on the shins, with keratin-derived amyloid deposits in the papillary dermis.

Why is "Prurigo nodularis" not the answer?

Prurigo nodularis shows nodules without amyloid.

Why is "Hypertrophic lichen planus" not the answer?

Hypertrophic lichen planus lacks amyloid.

Why is "Lichen simplex chronicus" not the answer?

Lichen simplex chronicus lacks amyloid on biopsy.

What concept does this question test?

It tests Metabolic skin signs: lichen amyloidosis in Dermatology. Chronic scratching is the driver. Treatment is potent steroids and breaking the itch-scratch cycle.

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 Metabolic skin signs: lichen amyloidosis?

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.