Papulosquamous disorders: aquagenic pruritus: 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: aquagenic pruritus

Sample item

A 58-year-old man with a ruddy face develops intense prickling itch within minutes of a warm bath, with no rash. Which investigation is most useful?

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

The answer and the reasoning

D. Complete blood count with JAK2 testing

Aquagenic pruritus is itch after contact with water of any temperature, with no visible rash. It can precede polycythaemia vera, so a blood count and JAK2 V617F testing are done.

Option by option

  • A. Skin prick testing

    Skin prick tests identify IgE-mediated allergy to allergens, not water-triggered itch.

  • B. Skin biopsy with direct immunofluorescence

    Direct immunofluorescence evaluates bullous disease, and there are no lesions here.

  • C. Serum total IgE

    Total IgE is raised in atopy and does not explain bath-triggered itch.

  • D. Complete blood count with JAK2 testing (correct)

    Correct. Water-induced itch with plethora suggests polycythaemia vera, which needs a CBC and JAK2.

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 D, Complete blood count with JAK2 testing. Aquagenic pruritus is itch after contact with water of any temperature, with no visible rash.

Why is "Skin prick testing" not the answer?

Skin prick tests identify IgE-mediated allergy to allergens, not water-triggered itch.

Why is "Skin biopsy with direct immunofluorescence" not the answer?

Direct immunofluorescence evaluates bullous disease, and there are no lesions here.

Why is "Serum total IgE" not the answer?

Total IgE is raised in atopy and does not explain bath-triggered itch.

What concept does this question test?

It tests Papulosquamous disorders: aquagenic pruritus in Dermatology. It can precede polycythaemia vera, so a blood count and JAK2 V617F testing are done.

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 Papulosquamous disorders: aquagenic pruritus?

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.