Papulosquamous disorders: pityriasis lichenoides et varioliformis acuta: 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 lichenoides et varioliformis acuta

Sample item

A 19-year-old has crops of reddish-brown papules in different stages. Some have haemorrhagic crusts, and they heal with varioliform scars. Biopsy shows a wedge-shaped infiltrate with extravasated red cells and keratinocyte necrosis. What is the diagnosis?

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

The answer and the reasoning

C. Pityriasis lichenoides et varioliformis acuta

PLEVA is a self-limiting papulonecrotic eruption of young adults and children, with crops of lesions at various stages. Lymphomatoid papulosis has CD30-positive atypical large cells, and the two are separated on histology.

Option by option

  • A. Secondary syphilis

    Secondary syphilis gives coppery papules with positive serology and no necrotic crusts.

  • B. Varicella

    Varicella gives clear vesicles on an erythematous base with fever, over a few days.

  • C. Pityriasis lichenoides et varioliformis acuta (correct)

    Correct. Crops of papules with haemorrhagic crusts and varioliform scars indicate PLEVA.

  • D. Lymphomatoid papulosis

    Lymphomatoid papulosis shows atypical CD30-positive large cells on biopsy.

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 C, Pityriasis lichenoides et varioliformis acuta. PLEVA is a self-limiting papulonecrotic eruption of young adults and children, with crops of lesions at various stages.

Why is "Secondary syphilis" not the answer?

Secondary syphilis gives coppery papules with positive serology and no necrotic crusts.

Why is "Varicella" not the answer?

Varicella gives clear vesicles on an erythematous base with fever, over a few days.

Why is "Lymphomatoid papulosis" not the answer?

Lymphomatoid papulosis shows atypical CD30-positive large cells on biopsy.

What concept does this question test?

It tests Papulosquamous disorders: pityriasis lichenoides et varioliformis acuta in Dermatology. Lymphomatoid papulosis has CD30-positive atypical large cells, and the two are separated on histology.

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: pityriasis lichenoides et varioliformis acuta?

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.