Leprosy: mechanism of thalidomide in ENL: 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 · Leprosy: mechanism of thalidomide in ENL

Sample item

Thalidomide is very effective in severe erythema nodosum leprosum mainly because it suppresses which mediator that is raised in the lesions and the serum?

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

The answer and the reasoning

B. Tumour necrosis factor alpha

TNF alpha is markedly raised in ENL and drives fever and neutrophilic inflammation. Thalidomide accelerates degradation of TNF alpha messenger RNA, which explains its rapid effect.

Option by option

  • A. Interleukin-4

    Interleukin-4 is a Th2 cytokine and is not the target of thalidomide in ENL.

  • B. Tumour necrosis factor alpha (correct)

    Correct. Thalidomide lowers TNF alpha, which is central to ENL.

  • C. Transforming growth factor beta

    TGF beta is an immunosuppressive cytokine and is not what thalidomide reduces in ENL.

  • D. Interferon gamma

    Interferon gamma is the macrophage-activating cytokine of the tuberculoid pole, not the ENL mediator.

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 B, Tumour necrosis factor alpha. TNF alpha is markedly raised in ENL and drives fever and neutrophilic inflammation.

Why is "Interleukin-4" not the answer?

Interleukin-4 is a Th2 cytokine and is not the target of thalidomide in ENL.

Why is "Transforming growth factor beta" not the answer?

TGF beta is an immunosuppressive cytokine and is not what thalidomide reduces in ENL.

Why is "Interferon gamma" not the answer?

Interferon gamma is the macrophage-activating cytokine of the tuberculoid pole, not the ENL mediator.

What concept does this question test?

It tests Leprosy: mechanism of thalidomide in ENL in Dermatology. Thalidomide accelerates degradation of TNF alpha messenger RNA, which explains its rapid effect.

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 Leprosy: mechanism of thalidomide in ENL?

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.