Papulosquamous disorders: trigger of generalised pustular psoriasis: 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 · Papulosquamous disorders: trigger of generalised pustular psoriasis

Sample item

A man with plaque psoriasis develops fever and widespread sterile pustules over red skin. Which event in the preceding fortnight most likely precipitated this?

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

The answer and the reasoning

C. Abrupt withdrawal of long-term oral corticosteroids

Abrupt withdrawal of systemic corticosteroids is a classic precipitant of the von Zumbusch pustular flare of psoriasis, along with infections, pregnancy, hypocalcaemia and irritants. Systemic steroids are therefore avoided in psoriasis, or tapered cautiously if unavoidable.

Option by option

  • A. Starting a vitamin D analogue ointment

    A vitamin D analogue ointment is a standard topical treatment and is not a recognised trigger of a pustular flare.

  • B. Regular use of emollients

    Emollients are safe and help plaque psoriasis.

  • C. Abrupt withdrawal of long-term oral corticosteroids (correct)

    Correct. Stopping systemic steroids abruptly can provoke generalised pustular psoriasis.

  • D. A course of narrowband UVB phototherapy

    Narrowband UVB is a standard treatment and typically improves plaque psoriasis.

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 C, Abrupt withdrawal of long-term oral corticosteroids. Abrupt withdrawal of systemic corticosteroids is a classic precipitant of the von Zumbusch pustular flare of psoriasis, along with infections, pregnancy, hypocalcaemia and irritants.

Why is "Starting a vitamin D analogue ointment" not the answer?

A vitamin D analogue ointment is a standard topical treatment and is not a recognised trigger of a pustular flare.

Why is "Regular use of emollients" not the answer?

Emollients are safe and help plaque psoriasis.

Why is "A course of narrowband UVB phototherapy" not the answer?

Narrowband UVB is a standard treatment and typically improves plaque psoriasis.

What concept does this question test?

It tests Papulosquamous disorders: trigger of generalised pustular psoriasis in Dermatology. Systemic steroids are therefore avoided in psoriasis, or tapered cautiously if unavoidable.

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 Papulosquamous disorders: trigger of generalised pustular psoriasis?

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.