Dermatology · Papulosquamous Disorders (Psoriasis, Lichen Planus)

A 25-year-old woman develops a single oval erythematous plaque with a collarette of scale on her trunk, followed 10 days later by multiple smaller oval lesions along the rib lines in a 'Christmas tree' pattern on her back. The most likely diagnosis is:

  • A Guttate psoriasis
  • B Pityriasis rosea
  • C Secondary syphilis
  • D Pityriasis versicolor
Correct answer: B. Pityriasis rosea

Explanation

Pityriasis rosea classically begins with a herald patch followed by secondary lesions distributed along Langer lines in a Christmas tree pattern. Guttate psoriasis lacks a herald patch and has thicker silvery scale. Secondary syphilis involves palms and soles with copper-colored lesions. Pityriasis versicolor shows hypopigmented macules with fine scale, not a Christmas tree distribution.

Reference: Bolognia's Dermatology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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