Pigmentary disorders: haemochromatosis pigmentation: 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 · Pigmentary disorders: haemochromatosis pigmentation

Sample item

A 50-year-old man has a diffuse bronze-grey skin colour, diabetes mellitus and a firm enlarged liver. Which statement about the pigmentation is correct?

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

The answer and the reasoning

D. It is due to melanin increase together with haemosiderin in the dermis

Hereditary haemochromatosis causes iron overload, with a metallic grey or bronze skin colour from increased epidermal melanin and dermal haemosiderin, especially on exposed sites and flexures. Diabetes and hepatomegaly form the classic bronze diabetes picture. Treatment is regular phlebotomy.

Option by option

  • A. It is due to bilirubin deposition in the skin

    Bilirubin gives a yellow-green hue with scleral staining, not bronze.

  • B. It is due to silver deposition

    Silver (argyria) gives a blue-grey colour after exposure to silver compounds.

  • C. It is due to carotenoid accumulation

    Carotenoids give a yellow-orange tint that spares the sclera, and they are not linked to the liver and diabetes.

  • D. It is due to melanin increase together with haemosiderin in the dermis (correct)

    Correct. Melanin and dermal haemosiderin together produce the bronze discolouration.

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.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, It is due to melanin increase together with haemosiderin in the dermis. Hereditary haemochromatosis causes iron overload, with a metallic grey or bronze skin colour from increased epidermal melanin and dermal haemosiderin, especially on exposed sites and flexures.

Why is "It is due to bilirubin deposition in the skin" not the answer?

Bilirubin gives a yellow-green hue with scleral staining, not bronze.

Why is "It is due to silver deposition" not the answer?

Silver (argyria) gives a blue-grey colour after exposure to silver compounds.

Why is "It is due to carotenoid accumulation" not the answer?

Carotenoids give a yellow-orange tint that spares the sclera, and they are not linked to the liver and diabetes.

What concept does this question test?

It tests Pigmentary disorders: haemochromatosis pigmentation in Dermatology. Diabetes and hepatomegaly form the classic bronze diabetes picture. Treatment is regular phlebotomy.

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 Pigmentary disorders: haemochromatosis pigmentation?

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.