Urticaria: urticarial vasculitis: 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 · Urticaria: urticarial vasculitis

Sample item

A 40-year-old woman has burning wheals lasting 2 to 3 days each, which fade leaving bruise-like hyperpigmentation. ESR is raised and C3 and C4 are low. Which investigation will confirm the diagnosis?

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

The answer and the reasoning

A. Skin biopsy of a fresh wheal

Wheals lasting beyond 24 hours that burn and leave purpura or pigmentation, with hypocomplementaemia, suggest urticarial vasculitis. Biopsy shows leukocytoclastic vasculitis, which confirms it. Ordinary urticaria resolves within 24 hours without residual marks.

Option by option

  • A. Skin biopsy of a fresh wheal (correct)

    Correct. Biopsy showing leukocytoclastic vasculitis confirms urticarial vasculitis.

  • B. Patch test

    Patch tests detect delayed contact hypersensitivity.

  • C. Serum tryptase alone

    Tryptase suggests mastocytosis or anaphylaxis, not vasculitic wheals.

  • D. Prick test with food allergens

    Food prick tests address IgE-mediated allergy, which does not explain this picture.

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 A, Skin biopsy of a fresh wheal. Wheals lasting beyond 24 hours that burn and leave purpura or pigmentation, with hypocomplementaemia, suggest urticarial vasculitis.

Why is "Patch test" not the answer?

Patch tests detect delayed contact hypersensitivity.

Why is "Serum tryptase alone" not the answer?

Tryptase suggests mastocytosis or anaphylaxis, not vasculitic wheals.

Why is "Prick test with food allergens" not the answer?

Food prick tests address IgE-mediated allergy, which does not explain this picture.

What concept does this question test?

It tests Urticaria: urticarial vasculitis in Dermatology. Biopsy shows leukocytoclastic vasculitis, which confirms it. Ordinary urticaria resolves within 24 hours without residual marks.

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 Urticaria: urticarial vasculitis?

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.