Drug reactions: hypersensitivity vasculitis: 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 · Drug reactions: hypersensitivity vasculitis

Sample item

Eight days after starting a beta-lactam antibiotic, a man has palpable purpura on the legs. Biopsy shows neutrophil infiltration with nuclear dust and fibrinoid change of small vessels, and there is no organ involvement. What is the first step?

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

The answer and the reasoning

D. Stop the offending drug and give supportive care

Drug-induced cutaneous small vessel (leukocytoclastic) vasculitis typically appears 7 to 10 days after the drug is started. When disease is limited to skin, withdrawal of the culprit with supportive care is usually sufficient. Systemic immunosuppression is reserved for organ involvement.

Option by option

  • A. Start long-term azathioprine

    Long-term azathioprine is unnecessary when the trigger is removed and the disease is skin limited.

  • B. Start intravenous cyclophosphamide

    Cyclophosphamide is reserved for severe systemic vasculitis, not skin-limited drug-induced disease.

  • C. Give plasmapheresis

    Plasmapheresis is not indicated for limited cutaneous vasculitis.

  • D. Stop the offending drug and give supportive care (correct)

    Correct. Withdrawing the culprit drug is usually enough for skin-limited disease.

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.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, Stop the offending drug and give supportive care. Drug-induced cutaneous small vessel (leukocytoclastic) vasculitis typically appears 7 to 10 days after the drug is started.

Why is "Start long-term azathioprine" not the answer?

Long-term azathioprine is unnecessary when the trigger is removed and the disease is skin limited.

Why is "Start intravenous cyclophosphamide" not the answer?

Cyclophosphamide is reserved for severe systemic vasculitis, not skin-limited drug-induced disease.

Why is "Give plasmapheresis" not the answer?

Plasmapheresis is not indicated for limited cutaneous vasculitis.

What concept does this question test?

It tests Drug reactions: hypersensitivity vasculitis in Dermatology. When disease is limited to skin, withdrawal of the culprit with supportive care is usually sufficient. Systemic immunosuppression is reserved for organ involvement.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Drug reactions: hypersensitivity vasculitis?

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.