Dermato-oncology: cutaneous lymphoma: 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 · Dermato-oncology: cutaneous lymphoma

Sample item

A 62-year-old man has had scaly patches on the buttocks and trunk for 8 years, labelled eczema and resistant to topical steroids. A biopsy shows atypical CD4+ T lymphocytes in the epidermis forming Pautrier microabscesses. What is the diagnosis?

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

The answer and the reasoning

C. Mycosis fungoides

Mycosis fungoides is the commonest cutaneous T-cell lymphoma, progressing slowly from patches to plaques to tumours. The characteristic histology is epidermotropism of atypical CD4+ T cells with Pautrier microabscesses. Early disease is treated with topical steroids, phototherapy or topical chemotherapy, and advanced disease with systemic agents. Sézary syndrome is the leukaemic variant with erythroderma.

Option by option

  • A. Lichen planus

    Lichen planus shows a band-like lichenoid infiltrate with sawtooth rete ridges.

  • B. Atopic dermatitis

    Atopic dermatitis shows spongiosis with a mixed inflammatory infiltrate.

  • C. Mycosis fungoides (correct)

    Correct. Epidermotropic atypical T cells with Pautrier microabscesses define the disease.

  • D. Psoriasis

    Psoriasis shows parakeratosis and regular acanthosis with Munro microabscesses.

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, Mycosis fungoides. Mycosis fungoides is the commonest cutaneous T-cell lymphoma, progressing slowly from patches to plaques to tumours.

Why is "Lichen planus" not the answer?

Lichen planus shows a band-like lichenoid infiltrate with sawtooth rete ridges.

Why is "Atopic dermatitis" not the answer?

Atopic dermatitis shows spongiosis with a mixed inflammatory infiltrate.

Why is "Psoriasis" not the answer?

Psoriasis shows parakeratosis and regular acanthosis with Munro microabscesses.

What concept does this question test?

It tests Dermato-oncology: cutaneous lymphoma in Dermatology. The characteristic histology is epidermotropism of atypical CD4+ T cells with Pautrier microabscesses. Early disease is treated with topical steroids, phototherapy or topical chemotherapy, and advanced disease with systemic agents. Sézary syndrome is the leukaemic variant with erythroderma.

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 Dermato-oncology: cutaneous lymphoma?

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.