Papulosquamous disorders: pityriasis rubra pilaris: 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: pityriasis rubra pilaris

Sample item

A man has orange-red scaly plaques with follicular papules and well-demarcated islands of normal skin, plus waxy orange palmoplantar keratoderma. Which is the most likely diagnosis?

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

The answer and the reasoning

A. Pityriasis rubra pilaris

Pityriasis rubra pilaris presents with salmon-orange erythema, follicular hyperkeratosis, nutmeg-grater papules and islands of sparing. Acitretin and methotrexate are treatments, and biologics are used in refractory disease.

Option by option

  • A. Pityriasis rubra pilaris (correct)

    Correct. Islands of sparing with orange palmoplantar keratoderma are characteristic.

  • B. Mycosis fungoides

    Mycosis fungoides has patches and plaques with atypical lymphocytes.

  • C. Pityriasis versicolor

    Pityriasis versicolor is a fine scaling pigment disorder.

  • D. Plaque psoriasis

    Psoriasis has thick silvery scale and rarely islands of sparing.

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 A, Pityriasis rubra pilaris. Pityriasis rubra pilaris presents with salmon-orange erythema, follicular hyperkeratosis, nutmeg-grater papules and islands of sparing.

Why is "Mycosis fungoides" not the answer?

Mycosis fungoides has patches and plaques with atypical lymphocytes.

Why is "Pityriasis versicolor" not the answer?

Pityriasis versicolor is a fine scaling pigment disorder.

Why is "Plaque psoriasis" not the answer?

Psoriasis has thick silvery scale and rarely islands of sparing.

What concept does this question test?

It tests Papulosquamous disorders: pityriasis rubra pilaris in Dermatology. Acitretin and methotrexate are treatments, and biologics are used in refractory disease.

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: pityriasis rubra pilaris?

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.