Infections: bacterial, viral, fungal, parasitic: HIV-associated eosinophilic folliculitis: 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 · Infections: bacterial, viral, fungal, parasitic: HIV-associated eosinophilic folliculitis

Sample item

A man with advanced HIV infection and a CD4 count of 80 per microlitre has intensely itchy follicular papules and sterile pustules on the face, upper trunk and extensor arms. Bacterial and fungal cultures are negative, and biopsy shows a perifollicular infiltrate rich in eosinophils. Which long-term measure is most likely to clear the condition?

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

The answer and the reasoning

B. Starting effective antiretroviral therapy

Eosinophilic pustular folliculitis occurs in advanced HIV disease with intense itch, and improves as immune reconstitution follows antiretroviral therapy. Interim control uses potent topical steroids, antihistamines, phototherapy or itraconazole. Antibiotics do not help because the pustules are sterile.

Option by option

  • A. Oral isotretinoin for all cases

    Isotretinoin is not a standard treatment and brings significant adverse effects.

  • B. Starting effective antiretroviral therapy (correct)

    Correct. Immune restoration with antiretroviral therapy is the key to remission.

  • C. Topical clotrimazole alone

    Topical clotrimazole does not treat this sterile inflammatory folliculitis.

  • D. Long-term oral flucloxacillin

    Antibiotics are ineffective for sterile eosinophilic pustules.

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 B, Starting effective antiretroviral therapy. Eosinophilic pustular folliculitis occurs in advanced HIV disease with intense itch, and improves as immune reconstitution follows antiretroviral therapy.

Why is "Oral isotretinoin for all cases" not the answer?

Isotretinoin is not a standard treatment and brings significant adverse effects.

Why is "Topical clotrimazole alone" not the answer?

Topical clotrimazole does not treat this sterile inflammatory folliculitis.

Why is "Long-term oral flucloxacillin" not the answer?

Antibiotics are ineffective for sterile eosinophilic pustules.

What concept does this question test?

It tests Infections: bacterial, viral, fungal, parasitic: HIV-associated eosinophilic folliculitis in Dermatology. Interim control uses potent topical steroids, antihistamines, phototherapy or itraconazole. Antibiotics do not help because the pustules are sterile.

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 Infections: bacterial, viral, fungal, parasitic: HIV-associated eosinophilic folliculitis?

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.