Papulosquamous disorders: prurigo nodularis: 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: prurigo nodularis

Sample item

A 55-year-old has intensely itchy, firm, hyperkeratotic nodules with excoriation on the extensor forearms and legs, sparing the mid upper back. Which diagnosis fits?

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

The answer and the reasoning

C. Prurigo nodularis

Prurigo nodularis forms firm excoriated nodules from chronic scratching, with sparing of unreachable skin (butterfly sign on the upper back). Treatment uses potent or intralesional steroids, with dupilumab as a newer systemic option. Underlying itch causes such as renal or liver disease should be sought.

Option by option

  • A. Nodular scabies only

    Nodular scabies occurs on genitals and axillae with a scabies history.

  • B. Dermatofibroma

    Dermatofibroma is a solitary asymptomatic firm nodule.

  • C. Prurigo nodularis (correct)

    Correct. Excoriated nodules with butterfly-sign sparing indicate prurigo nodularis.

  • D. Hypertrophic lichen planus

    Hypertrophic lichen planus has violaceous plaques on shins and shows Wickham striae.

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.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Prurigo nodularis. Prurigo nodularis forms firm excoriated nodules from chronic scratching, with sparing of unreachable skin (butterfly sign on the upper back).

Why is "Nodular scabies only" not the answer?

Nodular scabies occurs on genitals and axillae with a scabies history.

Why is "Dermatofibroma" not the answer?

Dermatofibroma is a solitary asymptomatic firm nodule.

Why is "Hypertrophic lichen planus" not the answer?

Hypertrophic lichen planus has violaceous plaques on shins and shows Wickham striae.

What concept does this question test?

It tests Papulosquamous disorders: prurigo nodularis in Dermatology. Treatment uses potent or intralesional steroids, with dupilumab as a newer systemic option. Underlying itch causes such as renal or liver disease should be sought.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: prurigo nodularis?

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.