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Tuesday, January 06, 2009

DOC for pregnant woman in 2nd trimester with pustular psoriasis Prednisolone

Question 59
DOC for pregnant woman in 2nd trimester with pustular psoriasis
a.       Prednisolone
b.      Dapsone
c.       Acitretin
d.      Methotrexate
Answer
a. Prednisolone
Reference :
Rook 6th Edition Chapter 35
QTDF
Rook
Quality
Reader
Status
Repeat
Discussion
Cytotoxic drugs, etretinate and PUVA cannot be used in GPP of pregnancy unless termination has become inevitable. Fulminating disease in pregnancy is best treated with prednisolone, the drug which carries the least hazard for the fetus, but methotrexate, retinoids, PUVA or combination therapy may be needed after delivery to allow weaning off the steroid.
Explanation
Self Explanatory : Based on Rook’s Text Book of dermatology
Comments
I have based my answer on the basis of Rook’s Text book of Surgery.
Any doubting Thomas who wants to Rook to see the answer for himself/ herself, can use the following guide to reach the correct page
Psoriasis à Pustular forms of Psoriasis à Generalised Pustular Psoriasis à Localised forms of GPP à Managementà Systemic Therapy
Tips
This was the question asked in AIPG 2005
The only definite indication for giving systemic corticosteroids in pustular psoriasis is:
1.         Psoriatic erythroderma with pregnancy.
2.         Psoriasis in a patient with alcoholic cirrhosis.
3.         Moderate arthritis.
4.         Extensive lesions.

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