The most appropriate laser to treat a port wine stain on an infant‟s cheek would have
which of the following wavelengths?
A. 488 nm
B. 532 nm
C. 585 nm
D. 694 nm
E. 810 nm





► C
The 585nm pulsed dye laser (PDL) targets intravascular oxyhemoglobin and is considered
the treatment of choice for most benign vascular lesions. The original PDL had a
wavelength of 577 nm which was later modified to 585 nm to achieve deeper
penetration yet still maintain vascular specificity.

Turge-Weber syndrome is a vascular malformation. It can occur in the first year of
life and more common in patients with bilateral port wine stains. The most common
neurologic abnormality is:
 a. Seizures
 b. Migraines
 c. Glaucoma
 d. Tram track calcification
 e. Tunnel vision






Answer   :    a. Seizures
Patients with Sturge-Weber have seizures as a common neurologic abnormality.
They can have glaucoma in 2/3 of patients at birth. Tram track calcifications don't
appear on XR before two years old.

A patient with a port wine stain covering one enlarged leg likely has which of the following
associated symptoms?
A. Lymphatic and deep venous insufficiency
B. Visceromegaly with omphalocele
C. Bilateral retinal hemangioblastomas
D. Enchondromas
E. Distichiasis







► A
Klippel-Trenaunay-Weber syndrome is a sporadic condition characterized by port-wine stains
typically covering one lower extremity that is enlarged with underlying lymphatic and deep
venous insufficiency

A patient with port wine stain on a lower extremity, hemihypertrophy of the limb and lymphatic
and deep venouse insufficiency of the affected limb would be considered to have Klippel Trenaunay-Weber syndrome. What additional feature would need to be present to define the
patient as having Parkes-Weber syndrome?
A. Arteriovenous fistulas
B. Multiple cafe-au-lait macules
C. Macroglossia
D. Cutis marmorata
E. Distichiasis






► A
Parkes-Weber syndrome has the additional feature of arteriovenous fistulas. The remaining
features are not part of these syndromes

An AIDS patient develops a smooth papule with a collarette of scale with vascular proliferation
seen on biopsy and is seen with those in contract with cats. The most likely cause of this is:
A. Bartonella hensalae
B. Brucellosis hensale
C. Pseudomonas mallei
D. Bacillus anthracis
E. Pasteurella

►A
This is bacillary angiomatosis and is caused by Bartonella hensalae and can be associated with
contact with cats in 20% of cases and occurs in patients with AIDS. The disease is treated with a
macrolide antibiotic or doxycycline.

Mycoplasma
A. The organism has a rigid cell wall
B. Does not grow in artificial media
C. Is associated with steven johnson syndrome
D. Agglutintion are raised in the infection
E. Antibiotics are not effective

Answer : D

An increase in cold agglutinin titers is frequently observed during M. pneumoniae infection; it has been reported that 50%-60% of these patients had cold agglutinins , which appear one week after the onset of the illness and decline toward undetectable levels after two to six weeks .

Tropical ulcer
A. Malnutrition is critical for its development
B. Staphylococcus is the cause
C. The floor of ulcer is pale and clear
D. Squamous cell carcinoma develops with in maximum of one year
E. Early grafting is a successful treatment

Answer : E

Tropical Ulcer
Tropical ulcers are an acute to chronic skin infection seen in remote tropical areas that often occur in clusters [43]. This infection is mainly seen in children, but also be observed in young adults. The lesions develop as small painful or itchy nodules on the feet or lower legs. The lesions break down suddenly to reveal an extensive area of deep but regular necrosis affecting the dermis and subcutis. In chronic lesions, complications such as osteomyelitis and squamous carcinomas, and secondary infection such as tetanus, may occur.
A characteristic feature of tropical ulcers is the presence of large numbers of bacteria including pleomorphic Gram-negative organisms as well as spiral bacteria. One bacterium consistently associated with early lesions is the anaerobe Fusobacterium ulcerans, which has also been isolated from microaerophilic sites in the environment such as mud or stagnant water. In experimentally inoculated mice the threshold for ulceration can be reduced considerably by co-infection of M. ulcerans and other bacteria such as E. coli .

#MCQ

A 3-year-old boy presented to dermatology OPD. His mother said he starts crying whenever they take him out in the sun. Examination showed scarring on the forehead and nose.
Which investigation will help you make a confirmatory diagnosis?

a- Skin biopsy for H/P
b- ANA
c- Anti-dsDNA
d- Urinary porphyrin levels
e- Direct immunofluorescence

Key: D (Erythropoietic protoporphyria)

This dermatophyte is not an anthropophilic organism:
 a. Trichophyton rubrum
 b. Epidermophyton floccosum
 c. Microsporum gypseum
 d. Microsporum audouinii
 e. Trichophyton soudanense

Key : c

Trichosporon ovoides is a cause of:
 a. Black piedra
 b. White piedra
 c. Tinea nigra palmaris
 d. Ectothrix tinea capitis
 e. Endothrix tinea capitis

Key : b

#MCQ
A patient is diagnosed with a unilateral enlargement of the medial clavicle after being diagnosed with congenital late syphilis. This is called the:
A. Higoumenaskis sign
B. Hutchinson's sign
C. Saber sign
D. Saddle sign
E. Gummas

Answer : A