Cutaneous tuberculosis: lichen scrofulosorum: 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 · Cutaneous tuberculosis: lichen scrofulosorum

Sample item

A child with tuberculous lymphadenitis develops asymptomatic, grouped, tiny skin-coloured follicular papules on the trunk. Smears and cultures are negative and the lesions regress with antitubercular treatment. What is the diagnosis?

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

The answer and the reasoning

D. Lichen scrofulosorum

Lichen scrofulosorum is a tuberculid, a hypersensitivity reaction to haematogenously spread antigens in a patient with active tuberculosis. Biopsy shows perifollicular granulomas and the response to antitubercular therapy is diagnostic.

Option by option

  • A. Keratosis pilaris

    Keratosis pilaris is a common follicular keratosis unrelated to TB.

  • B. Lichen nitidus

    Lichen nitidus has tiny shiny papules without TB association.

  • C. Lichen planus

    Lichen planus has pruritic violaceous flat papules and is not related to TB.

  • D. Lichen scrofulosorum (correct)

    Correct. A follicular papular tuberculid in a child with TB 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.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, Lichen scrofulosorum. Lichen scrofulosorum is a tuberculid, a hypersensitivity reaction to haematogenously spread antigens in a patient with active tuberculosis.

Why is "Keratosis pilaris" not the answer?

Keratosis pilaris is a common follicular keratosis unrelated to TB.

Why is "Lichen nitidus" not the answer?

Lichen nitidus has tiny shiny papules without TB association.

Why is "Lichen planus" not the answer?

Lichen planus has pruritic violaceous flat papules and is not related to TB.

What concept does this question test?

It tests Cutaneous tuberculosis: lichen scrofulosorum in Dermatology. Biopsy shows perifollicular granulomas and the response to antitubercular therapy is diagnostic.

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 Cutaneous tuberculosis: lichen scrofulosorum?

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.