Vesiculobullous disorders: infantile acropustulosis: 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 · Vesiculobullous disorders: infantile acropustulosis

Sample item

A 9-month-old has recurrent crops of intensely itchy vesicopustules on the palms and soles every few weeks. He was treated for scabies, but skin scrapings are negative, and the smear shows eosinophils. What is the best management?

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

The answer and the reasoning

A. Reassurance with a mild topical steroid and emollients

Infantile acropustulosis presents with recurrent, itchy vesicopustules of the hands and feet, and may follow scabies. It is self-limiting over a few years, so management is reassurance, emollients and mild topical steroids with an antihistamine to help sleep.

Option by option

  • A. Reassurance with a mild topical steroid and emollients (correct)

    Correct. This is a benign, self-limiting condition managed symptomatically.

  • B. Repeated permethrin applications

    Repeating scabicide is unnecessary when scrapings are negative.

  • C. Systemic immunosuppression

    Systemic immunosuppression is not justified for a benign self-resolving disorder.

  • D. Long-term oral antibiotics

    Antibiotics are not helpful since the pustules are sterile and eosinophilic.

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 A, Reassurance with a mild topical steroid and emollients. Infantile acropustulosis presents with recurrent, itchy vesicopustules of the hands and feet, and may follow scabies.

Why is "Repeated permethrin applications" not the answer?

Repeating scabicide is unnecessary when scrapings are negative.

Why is "Systemic immunosuppression" not the answer?

Systemic immunosuppression is not justified for a benign self-resolving disorder.

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

Antibiotics are not helpful since the pustules are sterile and eosinophilic.

What concept does this question test?

It tests Vesiculobullous disorders: infantile acropustulosis in Dermatology. It is self-limiting over a few years, so management is reassurance, emollients and mild topical steroids with an antihistamine to help sleep.

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 Vesiculobullous disorders: infantile acropustulosis?

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.