Cutaneous Manifestations of Systemic Disease (Diabetes, Internal Malignancy, Sarcoid) MCQs

Dermatology · 15 free questions with answers & explanations.

1. Acanthosis nigricans (AN) in adults most commonly signals insulin resistance. However, 'malignant AN' (rapid onset, extensive, involving oral mucosa and palms) is most strongly associated with which internal malignancy?
2. Necrolytic migratory erythema (NME) is the hallmark cutaneous sign of which internal tumour?
3. Necrobiosis lipoidica diabeticorum (NLD) characteristically presents as:
4. Lupus pernio is the pathognomonic skin lesion of sarcoidosis. Its histological description is:
5. A 55-year-old man with poorly-controlled diabetes develops velvety, hyperpigmented, thickened skin in the axillae and neck. He is later found to have a T2 gastric carcinoma. Which mechanism links these two entities through this dermatosis?
6. Necrobiosis lipoidica diabeticorum (NLD) most characteristically affects which anatomical site and shows which histological pattern?
7. Lupus pernio, which is the specific cutaneous marker of sarcoidosis, is characterised by which of the following clinical and histological features?
8. A patient with known small cell lung carcinoma develops progressive, symmetric hyperpigmentation of the intertriginous areas along with hypertrophic palmoplantar keratoderma (tripe palms). What is the paraneoplastic mediator most responsible?
9. A 55-year-old man presents with velvety, hyperpigmented, thickened skin in the axillae and posterior neck. He has not seen a doctor in years. On screening, a gastroscopy reveals an advanced gastric adenocarcinoma. This cutaneous sign is:
10. Necrobiosis lipoidica diabeticorum (NLD) is characterised by which histopathological pattern?
11. A young woman with known sarcoidosis develops violaceous, indurated plaques on her nose, cheeks, and earlobes — the lesions have been present for years and are associated with chronic pulmonary sarcoidosis. This specific cutaneous manifestation is called:
12. Scleredema adultorum of Buschke differs from diabetic thick skin (scleroderma diabeticorum) in which key way?
13. A 55-year-old man with poorly controlled type 2 diabetes presents with well-demarcated yellowish-brown atrophic plaques with violaceous border on the anterior shins. There are dilated capillaries visible within the atrophic plaques. No ulceration currently. The diagnosis is:
14. A 45-year-old man presents with sudden-onset of velvety, hyperpigmented, thickened skin in the axillae and nape of neck. He is non-obese with no family history of similar changes. The lesions have appeared over 3 months and are rapidly progressive. The most important next step is:
15. A 40-year-old woman presents with multiple translucent papules on the eyelids and periorbital skin that are yellowish in colour. She has mild elevation of total cholesterol. Biopsy shows collections of lipid-laden macrophages (foam cells) in the dermis. The primary lipid deposited in xanthelasma and eruptive xanthomas of hypertriglyceridaemia respectively are: