Papulosquamous disorders: erythema elevatum diutinum: 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 disorders: erythema elevatum diutinum

Sample item

A man with an IgA paraprotein has symmetric, persistent red-purple-brown nodules and plaques over the knuckles, elbows and knees. Biopsy shows leukocytoclastic vasculitis in early lesions and fibrosis in older ones. Which drug is the treatment of choice?

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

The answer and the reasoning

B. Dapsone

Erythema elevatum diutinum is a chronic neutrophil-mediated small-vessel vasculitis over extensor surfaces, associated with IgA gammopathy, infections such as HIV and streptococci, and haematological disease. Dapsone is the first-line therapy and typically works quickly. Lesions often recur when it is stopped.

Option by option

  • A. Isotretinoin

    Isotretinoin is used in acne and keratinisation disorders, not in this vasculitis.

  • B. Dapsone (correct)

    Correct. Dapsone suppresses the neutrophilic vasculitis and is the standard first-line drug.

  • C. Griseofulvin

    Griseofulvin is an antifungal for tinea and has no role in vasculitis.

  • D. Terbinafine

    Terbinafine is used for dermatophyte infections and is not effective for vasculitis.

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, Dapsone. Erythema elevatum diutinum is a chronic neutrophil-mediated small-vessel vasculitis over extensor surfaces, associated with IgA gammopathy, infections such as HIV and streptococci, and haematological disease.

Why is "Isotretinoin" not the answer?

Isotretinoin is used in acne and keratinisation disorders, not in this vasculitis.

Why is "Griseofulvin" not the answer?

Griseofulvin is an antifungal for tinea and has no role in vasculitis.

Why is "Terbinafine" not the answer?

Terbinafine is used for dermatophyte infections and is not effective for vasculitis.

What concept does this question test?

It tests Papulosquamous disorders: erythema elevatum diutinum in Dermatology. Dapsone is the first-line therapy and typically works quickly. Lesions often recur when it is stopped.

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 disorders: erythema elevatum diutinum?

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.