Connective Tissue Disorders in Skin (Lupus, Scleroderma) MCQs

Dermatology · 19 free questions with answers & explanations.

1. A 30-year-old woman presents with a well-defined erythematous plaque on the cheek with follicular plugging, adherent scales, and central scarring. Removing the scale reveals carpet-tack sign on the undersurface. What is the diagnosis?
2. A 45-year-old woman with systemic sclerosis presents with Raynaud's phenomenon, tight bound-down skin on the fingers, and calcium deposits under the skin of fingers. DIF shows homogeneous granular deposits at the DEJ. Which antibody is associated with limited cutaneous systemic sclerosis (CREST syndrome)?
3. A patient with subacute cutaneous lupus erythematosus (SCLE) has annular polycyclic lesions on the upper back. The antibody most specifically associated with SCLE is:
4. In diffuse systemic sclerosis, the antibody most associated with pulmonary fibrosis and worst prognosis is:
5. Dermatomyositis with heliotrope rash and Gottron's papules is associated with increased risk of malignancy. Which antibody is specifically associated with interstitial lung disease (ILD) in the anti-synthetase syndrome?
6. A 30-year-old woman with cutaneous lupus shows the 'lupus band' on DIF of non-sun-exposed normal skin. This finding indicates:
7. Morphoea (localized scleroderma) differs from systemic sclerosis in which of the following features?
8. In systemic lupus erythematosus, the 'lupus band test' (LBT) is positive. In sun-exposed normal skin of SLE patients, what immunoreactants are typically deposited at the DEJ?
9. A patient with diffuse cutaneous systemic sclerosis is at highest risk for which life-threatening complication, and what antibody is most strongly associated with it?
10. A patient with limited cutaneous systemic sclerosis (lcSSc) develops digital ulcers and pitting scars on fingertips. The autoantibody most specifically associated with lcSSc (CREST syndrome) and its clinical significance are:
11. Histopathological examination of a skin biopsy from a patient with dermatomyositis shows perifascicular atrophy in the muscle biopsy. On the skin biopsy of Gottron's papules, which finding distinguishes dermatomyositis from systemic lupus erythematosus?
12. Anti-Scl-70 (anti-topoisomerase I) antibody in systemic sclerosis is a marker for which subtype and complication?
13. Subacute cutaneous lupus erythematosus (SCLE) has a strong association with which anti-nuclear antibody and which drug that most commonly induces SCLE?
14. Anti-topoisomerase I (anti-Scl-70) antibody in systemic sclerosis is specifically associated with which clinical subset and complication?
15. A patient with SLE develops a photosensitive annular, erythematous, scaly rash on the chest and upper arms. ANA is positive at high titre; anti-Ro/SSA and anti-La/SSB antibodies are positive. There are no renal or CNS features. The diagnosis is:
16. A 40-year-old woman with systemic sclerosis develops severe Raynaud's phenomenon with digital ulcers. Her serology shows anti-topoisomerase I (anti-Scl-70) antibody. Regarding her cutaneous sclerosis, the histopathological feature in late-stage scleroderma is:
17. Subacute cutaneous lupus erythematosus (SCLE) is strongly associated with which antibody and has which characteristic skin finding?
18. A 35-year-old woman presents with persistent erythema on the cheeks and nose for 6 months, photosensitivity, oral ulcers, and new-onset arthralgia. ANA is positive (1:320), anti-dsDNA is elevated, and C3/C4 are reduced. Skin biopsy shows interface dermatitis with IgG, IgM, and C3 at the DEJ on DIF (positive lupus band test). The lupus band test in normal sun-exposed skin of SLE patients shows deposits, while in SCLE it is limited to:
19. A 40-year-old woman has had Raynaud's phenomenon for 5 years, followed by puffy fingers (sclerodactyly), telangiectases on face and hands, and calcinosis in fingertips. ANA is positive with anti-centromere antibody (ACA). Pulmonary function tests show mild restrictive pattern. The likely diagnosis and its associated risk compared to diffuse SSc are: