Acne: acne fulminans: 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 · Acne: acne fulminans

Sample item

A 16-year-old boy with nodulocystic acne suddenly develops fever, joint pain, raised ESR and painful ulcerating crusted nodules on the chest and back. What is the best initial treatment?

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

The answer and the reasoning

D. Oral prednisolone, adding isotretinoin after the acute phase

Acne fulminans is a rare severe ulcerative acne with systemic features such as fever and arthralgia. Treatment starts with systemic corticosteroids, and isotretinoin is introduced at a low dose after inflammation settles because early high-dose isotretinoin can worsen it. Antibiotics are adjuncts.

Option by option

  • A. Oral antifungals

    Antifungals have no role.

  • B. High-dose isotretinoin alone from day 1

    High-dose isotretinoin from the start may precipitate worsening.

  • C. Topical benzoyl peroxide alone

    Benzoyl peroxide alone is inadequate.

  • D. Oral prednisolone, adding isotretinoin after the acute phase (correct)

    Correct. Steroids first, then isotretinoin, is the standard approach.

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, Oral prednisolone, adding isotretinoin after the acute phase. Acne fulminans is a rare severe ulcerative acne with systemic features such as fever and arthralgia.

Why is "Oral antifungals" not the answer?

Antifungals have no role.

Why is "High-dose isotretinoin alone from day 1" not the answer?

High-dose isotretinoin from the start may precipitate worsening.

Why is "Topical benzoyl peroxide alone" not the answer?

Benzoyl peroxide alone is inadequate.

What concept does this question test?

It tests Acne: acne fulminans in Dermatology. Treatment starts with systemic corticosteroids, and isotretinoin is introduced at a low dose after inflammation settles because early high-dose isotretinoin can worsen it. Antibiotics are adjuncts.

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 Acne: acne fulminans?

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.