Pigmentary disorders: poikiloderma of Civatte: 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.

Try it

Dermatology · Pigmentary disorders: poikiloderma of Civatte

Sample item

A fair-skinned 62-year-old woman has reticulate red-brown pigmentation with telangiectasia and fine atrophy on the lateral neck and upper chest, but the skin under the chin is spared. Why is that area spared?

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

The answer and the reasoning

B. It is shaded and receives less chronic sun exposure

Poikiloderma of Civatte is a photodamage dermatosis of the lateral neck and V of the chest, seen in fair-skinned middle-aged women. The shaded submental skin escapes because it receives little sun. Management is photoprotection, and pulsed dye or intense pulsed light can improve the redness.

Option by option

  • A. It has a thicker dermis that resists atrophy

    Dermal thickness does not explain the pattern, which follows sun exposure.

  • B. It is shaded and receives less chronic sun exposure (correct)

    Correct. The submental area is shaded, so chronic photodamage spares it.

  • C. It has a higher density of melanocytes

    Melanocyte density does not differ enough to explain the sparing of a shaded area.

  • D. It has a richer sebaceous gland supply

    Sebaceous supply does not determine the distribution of photodamage.

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, It is shaded and receives less chronic sun exposure. Poikiloderma of Civatte is a photodamage dermatosis of the lateral neck and V of the chest, seen in fair-skinned middle-aged women.

Why is "It has a thicker dermis that resists atrophy" not the answer?

Dermal thickness does not explain the pattern, which follows sun exposure.

Why is "It has a higher density of melanocytes" not the answer?

Melanocyte density does not differ enough to explain the sparing of a shaded area.

Why is "It has a richer sebaceous gland supply" not the answer?

Sebaceous supply does not determine the distribution of photodamage.

What concept does this question test?

It tests Pigmentary disorders: poikiloderma of Civatte in Dermatology. The shaded submental skin escapes because it receives little sun. Management is photoprotection, and pulsed dye or intense pulsed light can improve the redness.

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 Pigmentary disorders: poikiloderma of Civatte?

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.