Skin tumours: Merkel cell carcinoma: 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 · Skin tumours: Merkel cell carcinoma

Sample item

A 78-year-old has a rapidly growing, painless, firm violaceous nodule on the sun-exposed cheek. Biopsy shows small blue cells with perinuclear dot-like cytokeratin 20 staining. What is the association?

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

The answer and the reasoning

B. Merkel cell polyomavirus and ultraviolet exposure

Merkel cell carcinoma is an aggressive neuroendocrine skin tumour linked to Merkel cell polyomavirus and sun exposure, and is more frequent in the elderly and the immunosuppressed. Cytokeratin 20 gives a perinuclear dot pattern. Sentinel node assessment is part of staging.

Option by option

  • A. Epstein-Barr virus

    EBV is linked with lymphomas and nasopharyngeal carcinoma.

  • B. Merkel cell polyomavirus and ultraviolet exposure (correct)

    Correct. Merkel cell polyomavirus is the associated virus.

  • C. Human herpesvirus 8

    HHV-8 causes Kaposi sarcoma.

  • D. Human papillomavirus type 16

    HPV 16 is linked with cervical and anogenital cancers.

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.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is B, Merkel cell polyomavirus and ultraviolet exposure. Merkel cell carcinoma is an aggressive neuroendocrine skin tumour linked to Merkel cell polyomavirus and sun exposure, and is more frequent in the elderly and the immunosuppressed.

Why is "Epstein-Barr virus" not the answer?

EBV is linked with lymphomas and nasopharyngeal carcinoma.

Why is "Human herpesvirus 8" not the answer?

HHV-8 causes Kaposi sarcoma.

Why is "Human papillomavirus type 16" not the answer?

HPV 16 is linked with cervical and anogenital cancers.

What concept does this question test?

It tests Skin tumours: Merkel cell carcinoma in Dermatology. Cytokeratin 20 gives a perinuclear dot pattern. Sentinel node assessment is part of staging.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Skin tumours: Merkel cell carcinoma?

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.