WBR1002
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| Author | [[PageAuthor::Vidit Bhargava, M.B.B.S [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 2 CK |
| Main Category | MainCategory::Internal medicine |
| Sub Category | SubCategory::Dermatology |
| Prompt | [[Prompt::A 30 yr old male presents to the clinic with an erythematous, pruritic rash as shown below. The rash spares palms and soles, but involves the back and chest. What is the best treatment strategy at this point?
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| Answer A | AnswerA::Observe, as it is a self limiting condition. |
| Answer A Explanation | AnswerAExp::The condition is pityriasis rosea, which is a self limiting condition which usually resolves within 6-8 weeks. Hence, watchful observation is the best treatment strategy which can be followed by steroids if needed. |
| Answer B | [[AnswerB::Prescribe a topical high potency steroid.]] |
| Answer B Explanation | AnswerBExp::The condition usually requires no treatment unless the rash is severely itchy. In such a case a topical steroid may be prescribed for a short duration. |
| Answer C | AnswerC::Prescribe oral steroids for 4 weeks and gradually taper. |
| Answer C Explanation | AnswerCExp::Oral steroids are usually not required to treat pityriasis rosea. |
| Answer D | AnswerD::Prescribe antifungals such as terbinafine, Itraconazole. |
| Answer D Explanation | [[AnswerDExp::These antifungals are needed to treat pityriasis versicolor that is caused by fungus Malassezia furfur. Antifungals have no role in the treatment of pityriasis rosea.]] |
| Answer E | [[AnswerE::Single intramuscular dose of Benzathine Penicillin.]] |
| Answer E Explanation | [[AnswerEExp::It is the drug of choice for secondary syphilis, which is one of the chief medical conditions which need to be differentiated when considering a diagnosis of pityriasis rosea.]] |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation::Pityriasis rosea usually requires no treatment. In cases when the lesions are severely itchy, topical high potency steroids may be used. Oral steroids are almost never needed for treatment. Some cases may be benefited by UV light treatment. Educational Objective: It is a self limiting condition, requiring treatment with topical steroids only when severe manifestations are present. |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::pityriasis rosea |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |
