Cutaneous tuberculosis: 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 · Cutaneous tuberculosis

Sample item

A 20-year-old woman has a slowly enlarging reddish-brown plaque on her cheek for several years. On diascopy with a glass slide, the lesion shows an apple-jelly colour. What is the most likely diagnosis?

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

The answer and the reasoning

C. Lupus vulgaris

Lupus vulgaris is a common form of cutaneous tuberculosis in India, with slowly progressive, soft, reddish-brown plaques and nodules, usually on the face, and an apple-jelly colour on diascopy. Biopsy shows tuberculoid granulomas, and treatment is standard antitubercular therapy.

Option by option

  • A. Discoid lupus erythematosus

    Discoid lupus gives scaly atrophic plaques with follicular plugging and scarring.

  • B. Lepromatous leprosy

    Lepromatous leprosy gives multiple symmetrical infiltrated nodules and loss of eyebrows.

  • C. Lupus vulgaris (correct)

    Correct. Apple-jelly nodules on diascopy are characteristic.

  • D. Lupus pernio of sarcoidosis

    Lupus pernio of sarcoidosis gives violaceous plaques on the nose and cheeks, and is also granulomatous but is usually violaceous.

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 C, Lupus vulgaris. Lupus vulgaris is a common form of cutaneous tuberculosis in India, with slowly progressive, soft, reddish-brown plaques and nodules, usually on the face, and an apple-jelly colour on diascopy.

Why is "Discoid lupus erythematosus" not the answer?

Discoid lupus gives scaly atrophic plaques with follicular plugging and scarring.

Why is "Lepromatous leprosy" not the answer?

Lepromatous leprosy gives multiple symmetrical infiltrated nodules and loss of eyebrows.

Why is "Lupus pernio of sarcoidosis" not the answer?

Lupus pernio of sarcoidosis gives violaceous plaques on the nose and cheeks, and is also granulomatous but is usually violaceous.

What concept does this question test?

It tests Cutaneous tuberculosis in Dermatology. Biopsy shows tuberculoid granulomas, and treatment is standard antitubercular therapy.

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 Cutaneous tuberculosis?

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.