Genodermatoses: Mal de Meleda: 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 · Genodermatoses: Mal de Meleda

Sample item

Which feature distinguishes Mal de Meleda from other palmoplantar keratodermas?

AIsolated nail dystrophy onlyBOnset only in adulthoodCStrict limitation to pressure pointsDTransgrediens spread onto the dorsum of hands and feet in a glove and stocking pattern

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

The answer and the reasoning

D. Transgrediens spread onto the dorsum of hands and feet in a glove and stocking pattern

Mal de Meleda is an autosomal recessive keratoderma due to SLURP1 mutation, with diffuse thickening that spreads beyond the palms and soles onto the dorsal surfaces (transgrediens). It starts in infancy and often shows hyperhidrosis and malodour. Focal keratodermas affect pressure points.

Option by option

A. Isolated nail dystrophy only
Nail dystrophy alone is not the defining feature.
B. Onset only in adulthood
Onset is in infancy, not adulthood.
C. Strict limitation to pressure points
Pressure-point limitation describes focal keratodermas.
D. Transgrediens spread onto the dorsum of hands and feet in a glove and stocking pattern (correct)
Correct. Transgrediens glove and stocking spread is characteristic.

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.

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, Transgrediens spread onto the dorsum of hands and feet in a glove and stocking pattern. Mal de Meleda is an autosomal recessive keratoderma due to SLURP1 mutation, with diffuse thickening that spreads beyond the palms and soles onto the dorsal surfaces (transgrediens).

Why is "Isolated nail dystrophy only" not the answer?

Nail dystrophy alone is not the defining feature.

Why is "Onset only in adulthood" not the answer?

Onset is in infancy, not adulthood.

Why is "Strict limitation to pressure points" not the answer?

Pressure-point limitation describes focal keratodermas.

What concept does this question test?

It tests Genodermatoses: Mal de Meleda in Dermatology. It starts in infancy and often shows hyperhidrosis and malodour. Focal keratodermas affect pressure points.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Genodermatoses: Mal de Meleda?

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.