Papulosquamous: acquired perforating dermatosis: 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 · Papulosquamous: acquired perforating dermatosis

Sample item

A diabetic man on dialysis has intensely itchy umbilicated hyperkeratotic papules and nodules with a central keratotic plug on the limbs, appearing at sites of scratching. What is the diagnosis?

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

The answer and the reasoning

A. Acquired perforating dermatosis (Kyrle-type)

Acquired perforating dermatosis occurs in chronic kidney disease and diabetes, with transepidermal elimination of collagen or elastic material through a keratotic plug and a Koebner response to scratching. Treatment includes controlling itch, topical steroids and narrowband UVB. Darier disease is inherited with greasy crusted papules.

Option by option

  • A. Acquired perforating dermatosis (Kyrle-type) (correct)

    Correct. Umbilicated plugged papules in dialysis and diabetes indicate this dermatosis.

  • B. Darier disease

    Darier disease is a genetic ATP2A2 disorder with seborrhoeic distribution.

  • C. Prurigo nodularis from scabies

    Prurigo nodularis is a scratch-induced dome-shaped nodule without a central plug of eliminated material.

  • D. Molluscum contagiosum

    Molluscum papules are pearly and not linked to dialysis.

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 A, Acquired perforating dermatosis (Kyrle-type). Acquired perforating dermatosis occurs in chronic kidney disease and diabetes, with transepidermal elimination of collagen or elastic material through a keratotic plug and a Koebner response to scratching.

Why is "Darier disease" not the answer?

Darier disease is a genetic ATP2A2 disorder with seborrhoeic distribution.

Why is "Prurigo nodularis from scabies" not the answer?

Prurigo nodularis is a scratch-induced dome-shaped nodule without a central plug of eliminated material.

Why is "Molluscum contagiosum" not the answer?

Molluscum papules are pearly and not linked to dialysis.

What concept does this question test?

It tests Papulosquamous: acquired perforating dermatosis in Dermatology. Treatment includes controlling itch, topical steroids and narrowband UVB. Darier disease is inherited with greasy crusted papules.

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 Papulosquamous: acquired perforating dermatosis?

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.