{"id":36869,"date":"2026-05-27T05:53:29","date_gmt":"2026-05-27T00:23:29","guid":{"rendered":"https:\/\/atsixty.com\/?p=36869"},"modified":"2026-05-27T05:54:05","modified_gmt":"2026-05-27T00:24:05","slug":"papulosquamous-diseases-eczemas","status":"publish","type":"post","link":"https:\/\/atsixty.com\/index.php\/27\/05\/2026\/papulosquamous-diseases-eczemas\/","title":{"rendered":"Papulosquamous Diseases &amp; Eczemas"},"content":{"rendered":"\n\n\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Playfair+Display:ital,wght@0,400;0,600;0,700;1,400;1,600&#038;family=Source+Serif+4:ital,wght@0,300;0,400;0,600;1,400&#038;display=swap\" rel=\"stylesheet\">\n<style>\n\/* All styles namespaced to #psqe01 -- no bleed into WordPress theme *\/\n#psqe01 *,#psqe01 *::before,#psqe01 *::after{box-sizing:border-box;margin:0;padding:0}\n#psqe01{\n  --ter:#8B3D20;--ter-light:#B85A38;--ter-pale:#FDF0EB;--ter-dark:#6B2D14;\n  --correct:#2D6B47;--correct-bg:#EAF6EF;--correct-border:#3A9960;\n  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.mr-stem{font-size:0.9rem}#psqe01 .mr-opt-text{font-size:0.86rem}}\n<\/style>\n\n<div id=\"psqe01\">\n\n  <div class=\"mr-header\">\n    <div class=\"mr-eyebrow\">Morning Rounds &middot; Daily Clinical Quiz<\/div>\n    <div class=\"mr-title\">\n      Papulosquamous Diseases &amp; Eczemas<br><em>Clinical Dermatology<\/em>\n    <\/div>\n    <div class=\"mr-subtitle\">Five high-yield clinical cases &middot; +4 \/ &minus;1 scoring &middot; NEET-PG and INI-CET<\/div>\n    <div class=\"mr-chips\">\n      <span class=\"mr-chip\">5 Cases<\/span>\n      <span class=\"mr-chip\">+4 \/ &minus;1 scoring<\/span>\n      <span class=\"mr-chip\">Options reshuffled<\/span>\n    <\/div>\n  <\/div>\n\n  <div class=\"mr-sentinel\" id=\"psqe01-sentinel\"><\/div>\n\n  <div class=\"mr-progress\" id=\"psqe01-progress\">\n    <div class=\"mr-prog-inner\">\n      <div class=\"mr-pips\" id=\"psqe01-pips\"><\/div>\n    <\/div>\n  <\/div>\n\n  <div class=\"mr-body\">\n    <div id=\"psqe01-cases\"><\/div>\n    <div class=\"mr-submit-wrap\">\n      <button class=\"mr-btn\" id=\"psqe01-submit\">Submit for Debrief<\/button>\n    <\/div>\n    <div class=\"mr-score\" id=\"psqe01-score\">\n      <div class=\"mr-score-in\">\n        <div class=\"mr-score-ey\">Round Complete<\/div>\n        <div class=\"mr-ring\" id=\"psqe01-ring\">\n          <div class=\"mr-ring-in\">\n            <span class=\"mr-ring-pct\" id=\"psqe01-pct\">0%<\/span>\n            <span class=\"mr-ring-sub\">net<\/span>\n          <\/div>\n        <\/div>\n        <div class=\"mr-score-title\">Your Debrief<\/div>\n        <div class=\"mr-score-net\" id=\"psqe01-net\"><\/div>\n        <div class=\"mr-verdict\" id=\"psqe01-verdict\"><\/div>\n        <div class=\"mr-bands\">\n          <span class=\"mr-band mr-band-c\" id=\"psqe01-ct-c\"><\/span>\n          <span class=\"mr-band mr-band-w\" id=\"psqe01-ct-w\"><\/span>\n          <span class=\"mr-band mr-band-s\" id=\"psqe01-ct-s\"><\/span>\n        <\/div>\n        <button class=\"mr-retry\" id=\"psqe01-retry\">&#8635; New Round<\/button>\n      <\/div>\n    <\/div>\n  <\/div>\n<\/div>\n\n<script>\n(function () {\n  'use strict';\n\n  var NS    = 'psqe01';\n  var TOTAL = 5;\n  var MAX   = 20;\n  var LTRS  = ['A','B','C','D'];\n\n  \/* ================================================================\n     QUESTION BANK -- Papulosquamous Diseases & Eczemas\n     NEET-PG level. No superspeciality depth.\n     ================================================================\n\n     Q1  PSORIASIS -- AUSPITZ SIGN & HISTOLOGY (Easy-Medium)\n         Well-demarcated silvery-white scaly plaques on extensor\n         surfaces. Auspitz sign: removal of scale reveals pinpoint\n         bleeding (dilated capillaries in dermal papillae).\n         Histology: parakeratosis, Munro microabscesses (neutrophils\n         in stratum corneum), suprapapillary thinning, dilated\n         tortuous capillaries in dermal papillae.\n         Koebner phenomenon positive.\n         Nail: pitting (most common), onycholysis, subungual\n         hyperkeratosis, oil drop sign.\n         Answer: Auspitz sign due to dilated capillaries in dermal\n                 papillae exposed after scale removal\n\n     Q2  LICHEN PLANUS -- 4 Ps & WICKHAM STRIAE (Easy-Medium)\n         Pruritic, Purple, Polygonal, Papules -- the 4 Ps.\n         Wickham striae: white lacy pattern on surface of papules\n         (due to focal hypergranulosis).\n         Sites: flexor aspects of wrists, ankles, oral mucosa.\n         Oral LP: white reticular pattern on buccal mucosa --\n         most common oral premalignant lesion (erosive type).\n         Koebner phenomenon positive.\n         Histology: saw-tooth rete ridges, band-like lymphocytic\n         infiltrate at DEJ, civatte bodies (apoptotic keratinocytes),\n         hypergranulosis.\n         Answer: Wickham striae due to focal hypergranulosis in the\n                 granular layer\n\n     Q3  PITYRIASIS ROSEA -- HERALD PATCH & CHRISTMAS TREE (Easy)\n         Self-limiting; young adults; follows upper respiratory\n         infection (HHV-6\/7 association).\n         Herald patch: single large oval lesion 1-2 weeks before\n         generalised eruption.\n         Christmas tree pattern: oval lesions along skin cleavage\n         lines (Langer lines) on trunk -- classic on exam.\n         Collarette scaling (scaling from inner edge of lesion).\n         Spares face, scalp, palms, soles.\n         Resolves spontaneously in 6-8 weeks.\n         Answer: Herald patch precedes generalised eruption by\n                 1-2 weeks; lesions follow Langer lines in a\n                 Christmas tree pattern\n\n     Q4  ATOPIC DERMATITIS -- DISTRIBUTION BY AGE & IgE (Medium)\n         Infantile (< 2 yr): face, scalp, extensor surfaces.\n         Childhood (2-12 yr): flexural surfaces -- antecubital,\n         popliteal fossae.\n         Adult: flexural, lichenified, hand eczema.\n         Elevated total IgE; associated with asthma, allergic\n         rhinitis (atopic triad).\n         Dennie-Morgan lines: extra fold under lower eyelid.\n         Hertoghe sign: thinning of outer third of eyebrows.\n         Treatment: emollients (first line always); topical\n         corticosteroids; tacrolimus\/pimecrolimus (calcineurin\n         inhibitors) -- steroid-sparing, safe on face.\n         Answer: Flexural involvement in childhood; elevated IgE;\n                 part of the atopic triad with asthma and\n                 allergic rhinitis\n\n     Q5  CONTACT DERMATITIS -- ALLERGIC vs IRRITANT (Medium)\n         Irritant CD:\n           - Non-immunological; most common type overall\n           - Any person with sufficient exposure (detergents,\n             acids, alkalis)\n           - Confined strictly to area of contact\n           - Occurs on first exposure\n           - Patch test NEGATIVE\n         Allergic CD:\n           - Type IV hypersensitivity (delayed, T-cell mediated)\n           - Requires prior sensitisation -- minimum 10-14 days\n           - Can spread beyond contact area\n           - Patch test POSITIVE\n           - Most common allergen: nickel (jewellery, belt buckles)\n           - Parthenium dermatitis: common in India (airborne\n             contact dermatitis from Parthenium hysterophorus weed)\n         Answer: Allergic CD is Type IV hypersensitivity, requires\n                 prior sensitisation, patch test positive; Irritant\n                 CD is non-immunological, patch test negative\n     ================================================================ *\/\n\n  var QS = [\n\n    \/* ---- Q1 : Psoriasis ---- *\/\n    {\n      id:      1,\n      tag:     'Papulosquamous &mdash; Psoriasis',\n      stem:    'A <strong>35-year-old man<\/strong> presents with well-demarcated, <strong>silvery-white scaly plaques<\/strong> over both elbows and knees for two years. On gently scraping the scale, multiple <strong>pinpoint bleeding spots<\/strong> appear on the underlying surface. Which of the following correctly explains the sign elicited and its pathological basis?',\n      correct: 'Auspitz sign: removal of the parakeratotic scale exposes dilated, tortuous capillaries at the tips of dermal papillae, which bleed on trauma',\n      opts: [\n        'Auspitz sign: removal of the parakeratotic scale exposes dilated, tortuous capillaries at the tips of dermal papillae, which bleed on trauma',\n        'Nikolsky sign: lateral shear force causes epidermal separation at the dermo-epidermal junction due to acantholysis',\n        'Darier sign: stroking the lesion causes urtication due to mast cell degranulation in the dermis',\n        'Koebner phenomenon: new lesions appear at sites of trauma due to pathergic response of psoriatic skin'\n      ],\n      exp:     '<strong>Auspitz sign<\/strong> is pathognomonic of psoriasis. Scraping the silvery scale in layers first produces a <em>candle grease<\/em> appearance, then a shiny red membrane (<em>Bulkley membrane<\/em>), then pinpoint bleeding. This bleeding occurs because psoriatic epidermis has <strong>suprapapillary thinning<\/strong> &mdash; the epidermis directly overlying the dermal papillae is very thin &mdash; and the papillae contain <strong>dilated, tortuous capillaries<\/strong> that rupture when the overlying scale is removed. <strong>Key histology of psoriasis:<\/strong> parakeratosis (nuclei retained in stratum corneum), <strong>Munro microabscesses<\/strong> (neutrophil collections in stratum corneum), suprapapillary thinning, and dilated papillary capillaries. <strong>Nail changes<\/strong> (in order of frequency): pitting (most common), onycholysis, subungual hyperkeratosis, and the <em>oil drop (salmon patch) sign<\/em>. <strong>Extra point:<\/strong> Koebner phenomenon (new lesions at sites of trauma) is positive in psoriasis, lichen planus, and vitiligo &mdash; a classic exam triplet. Auspitz sign is <em>not<\/em> pathognomonic when bleeding occurs with minimal trauma in other conditions; the sign is specific only when positive in the classical stepwise scraping sequence.'\n    },\n\n    \/* ---- Q2 : Lichen Planus ---- *\/\n    {\n      id:      2,\n      tag:     'Papulosquamous &mdash; Lichen Planus',\n      stem:    'A <strong>40-year-old woman<\/strong> presents with intensely pruritic, <strong>flat-topped, violaceous papules<\/strong> on her flexor wrists and ankles. On close inspection, a <em>white lacy network<\/em> is visible on the surface of the papules. Similar white reticulate lesions are seen on her buccal mucosa. The white lacy pattern on the papule surface is caused by:',\n      correct: 'Focal hypergranulosis in the granular cell layer, which produces the white appearance clinically known as Wickham striae',\n      opts: [\n        'Focal hypergranulosis in the granular cell layer, which produces the white appearance clinically known as Wickham striae',\n        'Parakeratosis with neutrophil collections in the stratum corneum forming Munro microabscesses',\n        'Subepidermal blister formation with linear IgG deposits at the basement membrane zone',\n        'Intercellular oedema (spongiosis) in the spinous layer causing vesicle formation'\n      ],\n      exp:     '<strong>Lichen planus (LP)<\/strong> is remembered by the <strong>4 Ps: Pruritic, Purple (violaceous), Polygonal, Papules<\/strong>. The white lacy surface pattern is called <strong>Wickham striae<\/strong>, caused by <strong>focal hypergranulosis<\/strong> (thickening of the granular cell layer). <strong>Histology:<\/strong> saw-tooth rete ridges, <em>band-like<\/em> lymphocytic infiltrate hugging the dermo-epidermal junction, <strong>Civatte bodies<\/strong> (colloid bodies &mdash; apoptotic basal keratinocytes), and hypergranulosis. <strong>Oral LP:<\/strong> the white reticular pattern on buccal mucosa is the most common presentation; the <em>erosive type<\/em> is considered a potentially premalignant lesion. Koebner phenomenon is positive. <strong>Associations:<\/strong> hepatitis C virus (strong association, especially in Mediterranean countries), drugs (beta-blockers, antimalarials, thiazides &mdash; lichenoid drug reaction). <strong>Extra point:<\/strong> LP heals with <em>post-inflammatory hyperpigmentation<\/em> (not scarring) on skin, but erosive oral LP may rarely undergo malignant transformation to squamous cell carcinoma &mdash; the only form that carries this risk. This is a reliable exam distinction.'\n    },\n\n    \/* ---- Q3 : Pityriasis Rosea ---- *\/\n    {\n      id:      3,\n      tag:     'Papulosquamous &mdash; Pityriasis Rosea',\n      stem:    'A <strong>22-year-old woman<\/strong> notices a single <strong>large, oval, salmon-coloured patch<\/strong> with a collarette of scaling on her trunk. Two weeks later, multiple smaller similar lesions appear on her trunk, arranged in an oblique pattern following the skin cleavage lines. She had a mild upper respiratory tract infection three weeks ago. The most likely diagnosis and the characteristic distribution pattern of the secondary lesions are:',\n      correct: 'Pityriasis rosea; secondary lesions follow Langer lines on the trunk, producing a Christmas tree pattern on the back',\n      opts: [\n        'Pityriasis rosea; secondary lesions follow Langer lines on the trunk, producing a Christmas tree pattern on the back',\n        'Tinea corporis; secondary lesions spread centrifugally from the primary lesion with central clearing',\n        'Guttate psoriasis; multiple small lesions appear following streptococcal upper respiratory infection',\n        'Secondary syphilis; generalised rash including palms and soles following primary chancre resolution'\n      ],\n      exp:     '<strong>Pityriasis rosea (PR)<\/strong> follows a classic two-stage course. The <strong>herald patch<\/strong> (mother patch) appears first &mdash; a single large (2&ndash;5&nbsp;cm), oval, salmon-coloured lesion with a <em>collarette of fine scaling<\/em> from its inner edge. After 1&ndash;2 weeks, the generalised eruption follows. Secondary lesions are smaller, oval, oriented with their long axes along <strong>Langer cleavage lines<\/strong>, producing the classical <strong>Christmas tree pattern<\/strong> on the back. The face, scalp, palms, and soles are typically spared. The condition is <strong>self-limiting, resolving in 6&ndash;8 weeks<\/strong>. Association with <strong>HHV-6 and HHV-7<\/strong> reactivation is recognised. <strong>Extra point &mdash; important exam trap:<\/strong> secondary syphilis can mimic PR exactly, including a herald-like initial lesion, but it involves the <strong>palms and soles<\/strong> (PR does not) and the VDRL\/RPR will be positive. Any atypical PR &mdash; especially in a sexually active young adult &mdash; warrants syphilis serology. This is a high-yield clinical reasoning point for NEET-PG.'\n    },\n\n    \/* ---- Q4 : Atopic Dermatitis ---- *\/\n    {\n      id:      4,\n      tag:     'Eczema &mdash; Atopic Dermatitis',\n      stem:    'A <strong>7-year-old boy<\/strong> is brought with chronic, relapsing, intensely pruritic skin lesions. His mother reports he also has <strong>recurrent wheezing<\/strong> and seasonal sneezing. Examination shows <strong>lichenified plaques in the antecubital and popliteal fossae<\/strong> with excoriations. An extra fold is noted under both lower eyelids. Which statement correctly describes the distribution pattern in this age group and the immunological finding?',\n      correct: 'In childhood atopic dermatitis, lesions predominate in flexural areas; total serum IgE is elevated and the condition is associated with asthma and allergic rhinitis as part of the atopic triad',\n      opts: [\n        'In childhood atopic dermatitis, lesions predominate in flexural areas; total serum IgE is elevated and the condition is associated with asthma and allergic rhinitis as part of the atopic triad',\n        'In childhood atopic dermatitis, lesions predominate on extensor surfaces; IgG4 is elevated and the condition is associated with coeliac disease',\n        'In childhood atopic dermatitis, lesions predominate on the face and scalp; complement C3 is low due to immune complex deposition',\n        'In childhood atopic dermatitis, lesions predominate on the trunk; antinuclear antibodies are positive in the majority of cases'\n      ],\n      exp:     '<strong>Atopic dermatitis (AD)<\/strong> has an <strong>age-dependent distribution<\/strong> &mdash; one of the most reliably tested facts in NEET-PG Dermatology. <em>Infantile<\/em> (&lt;2&nbsp;yr): face (cheeks), scalp, extensor surfaces. <em>Childhood<\/em> (2&ndash;12&nbsp;yr): <strong>flexural areas<\/strong> &mdash; antecubital and popliteal fossae, wrists, ankles. <em>Adult<\/em>: flexural, lichenified, with hand eczema. The <strong>atopic triad<\/strong> &mdash; AD + asthma + allergic rhinitis &mdash; is driven by <strong>elevated total serum IgE<\/strong> and Th2-skewed immunity. <strong>Useful clinical signs:<\/strong> <em>Dennie-Morgan lines<\/em> (double fold under the lower eyelid, seen in this case); <em>Hertoghe sign<\/em> (thinning of the outer third of the eyebrows). <strong>Treatment hierarchy:<\/strong> <strong>emollients first and always<\/strong> (skin barrier dysfunction is the fundamental defect); topical corticosteroids for flares; <strong>topical calcineurin inhibitors<\/strong> (tacrolimus, pimecrolimus) as steroid-sparing agents, particularly on the face and flexures. <strong>Extra point:<\/strong> filaggrin gene (FLG) mutations are the strongest genetic risk factor for AD, causing skin barrier defects &mdash; this is the mechanism by which sensitisation to environmental allergens occurs (<em>outside-in hypothesis<\/em>).'\n    },\n\n    \/* ---- Q5 : Contact Dermatitis ---- *\/\n    {\n      id:      5,\n      tag:     'Eczema &mdash; Contact Dermatitis',\n      stem:    'A <strong>28-year-old woman<\/strong> develops a pruritic, vesicular rash <strong>strictly confined to her earlobes and wrists<\/strong> where she wears jewellery. She has been wearing the same jewellery for three years without any problem until six months ago. Patch testing is positive for nickel. The type of hypersensitivity reaction and its key distinguishing features from irritant contact dermatitis are:',\n      correct: 'Type IV (delayed-type) hypersensitivity; requires prior sensitisation; not possible on first exposure; patch test positive; can spread beyond contact area',\n      opts: [\n        'Type IV (delayed-type) hypersensitivity; requires prior sensitisation; not possible on first exposure; patch test positive; can spread beyond contact area',\n        'Type I (immediate) hypersensitivity; IgE-mediated mast cell degranulation; occurs within minutes of contact; patch test negative',\n        'Type II hypersensitivity; IgG antibodies against nickel-skin protein complexes; complement-mediated cytotoxicity; patch test negative',\n        'Type III hypersensitivity; immune complex deposition at dermo-epidermal junction; positive ANA; patch test negative'\n      ],\n      exp:     '<strong>Allergic contact dermatitis (ACD)<\/strong> is a classic <strong>Type IV (delayed-type) hypersensitivity<\/strong> reaction, T-cell mediated, with two phases: <em>sensitisation<\/em> (first exposure, no clinical reaction &mdash; takes 10&ndash;14 days minimum) and <em>elicitation<\/em> (subsequent exposures produce the rash within 24&ndash;72 hours). This explains why the patient wore the same jewellery for three years before reacting &mdash; sensitisation occurred silently. <strong>Nickel<\/strong> is the most common contact allergen worldwide. <strong>Patch test<\/strong> is the gold-standard investigation &mdash; positive in ACD, negative in irritant CD. <strong>Irritant contact dermatitis (ICD)<\/strong> is <em>non-immunological<\/em>, is the most common type of contact dermatitis overall, occurs on first exposure with sufficient concentration, is strictly confined to the contact area, and the patch test is negative. <strong>Extra point &mdash; India-specific:<\/strong> <strong>Parthenium dermatitis<\/strong> is a common cause of airborne contact dermatitis in India, caused by pollen of <em>Parthenium hysterophorus<\/em> (Congress grass), affecting exposed skin of the face, neck, and forearms. It is frequently tested in NEET-PG and is an ACD (Type IV). Another common India-specific cause: <em>bindi dermatitis<\/em> from para-tertiary butylphenol formaldehyde resin in adhesive bindis.'\n    }\n\n  ];\n  \/* ================================================================\n     END OF CONTENT -- engine logic below, do not edit\n     ================================================================ *\/\n\n  var answers  = {};\n  var answered = 0;\n  var shuffled = {};\n  var done     = false;\n\n  function byId(id) { return document.getElementById(id); }\n  function gid(sfx) { return byId(NS + '-' + sfx); }\n\n  function shuffleArr(arr) {\n    var a = arr.slice(), i, j, t;\n    for (i = a.length - 1; i > 0; i--) {\n      j = Math.floor(Math.random() * (i + 1));\n      t = a[i]; a[i] = a[j]; a[j] = t;\n    }\n    return a;\n  }\n\n  function countVal(val) {\n    var k, n = 0;\n    for (k in answers) {\n      if (answers.hasOwnProperty(k) && answers[k] === val) n++;\n    }\n    return n;\n  }\n\n  function buildPips() {\n    var cont = gid('pips'), i, q, wl, wp, line, pip;\n    if (!cont) return;\n    cont.innerHTML = '';\n    for (i = 0; i < QS.length; i++) {\n      q = QS[i];\n      if (i > 0) {\n        wl = document.createElement('div'); wl.className = 'mr-pip-wrap';\n        line = document.createElement('div'); line.className = 'mr-pip-line';\n        line.id = NS + '-pl' + q.id;\n        wl.appendChild(line); cont.appendChild(wl);\n      }\n      wp = document.createElement('div'); wp.className = 'mr-pip-wrap';\n      pip = document.createElement('div'); pip.className = 'mr-pip';\n      pip.id = NS + '-pip' + q.id; pip.textContent = String(q.id);\n      wp.appendChild(pip); cont.appendChild(wp);\n    }\n  }\n\n  function build() {\n    var cont, i, q, opts, card, top, nd, meta, tg, st,\n        rule, od, ed, lb, tx, j, oe, ls, ts;\n    cont = gid('cases');\n    if (!cont) return;\n    cont.innerHTML = '';\n    answers = {}; answered = 0; shuffled = {}; done = false;\n    if (gid('score')) gid('score').style.display = 'none';\n    buildPips();\n    for (i = 0; i < QS.length; i++) {\n      q    = QS[i];\n      opts = shuffleArr(q.opts);\n      shuffled[q.id] = opts;\n      card = document.createElement('div'); card.className = 'mr-case';\n      top  = document.createElement('div'); top.className  = 'mr-case-top';\n      nd   = document.createElement('div'); nd.className   = 'mr-num';\n      nd.textContent = q.id < 10 ? 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Dermatology holds no surprises for you.'],\n      [4, 'Strong \\u2014 one clinical sign to revisit before exam day.'],\n      [3, 'Solid base \\u2014 the India-specific points reward a second read.'],\n      [2, 'Halfway there \\u2014 the debrief panels have everything you need.'],\n      [0, 'These disorders reward persistence. Come back tomorrow.']\n    ];\n    var ve = gid('verdict');\n    if (ve) {\n      ve.textContent = vlist[4][1];\n      for (vi = 0; vi < vlist.length; vi++) {\n        if (c >= vlist[vi][0]) { ve.textContent = vlist[vi][1]; break; }\n      }\n    }\n    var cc = gid('ct-c'); if (cc) cc.textContent = '\\u2705 ' + c + ' Correct';\n    var cw = gid('ct-w'); if (cw) cw.textContent = '\\u274C ' + w + ' Wrong';\n    var cs = gid('ct-s'); if (cs) cs.textContent = '\\u23ED ' + s + ' Skipped';\n    sc = gid('score');\n    if (sc) { sc.style.display = 'block'; sc.scrollIntoView({ behavior: 'smooth', block: 'center' }); }\n  }\n\n  function initObserver() {\n    var sn = gid('sentinel'), bar = gid('progress');\n    if (!sn || !bar || !window.IntersectionObserver) return;\n    new IntersectionObserver(function (en) {\n      bar.className = en[0].isIntersecting ? 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