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|QuestionAuthor={{VB}}
|QuestionAuthor={{VB}}
|ExamType=USMLE Step 2 CK
|ExamType=USMLE Step 2 CK
|MainCategory=Internal medicine
|SubCategory=Dermatology
|SubCategory=Dermatology, Dermatology
|SubCategory=Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology
|SubCategory=Dermatology, Dermatology
|SubCategory=Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology
|SubCategory=Dermatology, Dermatology
|SubCategory=Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology
|SubCategory=Dermatology, Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology, Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology, Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology, Dermatology
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Dermatology, Dermatology
|Prompt=A 30 yr old male presents to the clinic with an [[erythematous]], pruritic rash as shown below. The rash spares palms and soles, but involves the back and chest. What is the best treatment strategy at this point?
|Prompt=A 30 yr old male presents to the clinic with an [[erythematous]], pruritic rash as shown below. The rash spares palms and soles, but involves the back and chest. What is the best treatment strategy at this point?


[[Image:Pityriasis versicolor.jpg|200px]]
[[Image:Pityriasis versicolor.jpg|200px]]
|Explanation=[[Pityriasis rosea]] usually requires no treatment. In cases when the lesions are severely itchy, topical high potency [[steroids]] may be used. Oral steroids are almost never needed for treatment. Some cases may be benefited by [[Psoriasis medical therapy#Phototherapy|UV light treatment]].  
|Explanation=[[Pityriasis rosea]] usually requires no treatment. In cases when the lesions are severely itchy, topical high potency [[steroids]] may be used. Oral steroids are almost never needed for treatment. Some cases may be benefited by [[Psoriasis medical therapy#Phototherapy|UV light treatment]].
 
|AnswerA=Observe, as it is a self limiting condition.
|AnswerA=Observe, as it is a self limiting condition.
|AnswerAExp=The condition is pityriasis rosea, which is a self limiting condition which usually resolves within 6-8 weeks. Hence, watchful observation is the best treatment strategy which can be followed by steroids if needed.
|AnswerAExp=The condition is pityriasis rosea, which is a self limiting condition which usually resolves within 6-8 weeks. Hence, watchful observation is the best treatment strategy which can be followed by steroids if needed.
|AnswerB=Prescribe a topical high potency [[steroid]].
|AnswerB=Prescribe a topical high potency [[steroid]].
|AnswerBExp=The condition usually requires no treatment unless the rash is severely itchy. In such a case a topical steroid may be prescribed for a short duration.
|AnswerBExp=The condition usually requires no treatment unless the rash is severely itchy. In such a case a topical steroid may be prescribed for a short duration.
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|AnswerCExp=Oral steroids are usually not required to treat pityriasis rosea.
|AnswerCExp=Oral steroids are usually not required to treat pityriasis rosea.
|AnswerD=Prescribe antifungals such as terbinafine, Itraconazole.
|AnswerD=Prescribe antifungals such as terbinafine, Itraconazole.
|AnswerDExp=These antifungals are needed to treat [[pityriasis versicolor]] that is caused by fungus [[Malassezia furfur]]. Antifungals have no role in the treatment of [[pityriasis rosea]].
|AnswerDExp=These antifungals are needed to treat [[pityriasis versicolor]] that is caused by fungus [[Malassezia furfur]]. Antifungals have no role in the treatment of [[pityriasis rosea]].
|AnswerE=Single intramuscular dose of [[Benzathine Penicillin]].
|AnswerE=Single intramuscular dose of [[Benzathine Penicillin]].
|AnswerEExp=It is the drug of choice for secondary syphilis, which is one of the chief medical conditions which need to be differentiated when considering a diagnosis of [[pityriasis rosea]].
|AnswerEExp=It is the drug of choice for secondary syphilis, which is one of the chief medical conditions which need to be differentiated when considering a diagnosis of [[pityriasis rosea]].
|EducationalObjectives=It is a self limiting condition, requiring treatment with topical steroids only when severe manifestations are present.  
|EducationalObjectives=It is a self limiting condition, requiring treatment with topical steroids only when severe manifestations are present.
|References=Page 101 FA STEP2CK
|References=Page 101 FA STEP2CK seventh edition
|RightAnswer=A
|RightAnswer=A
|WBRKeyword=pityriasis rosea
|WBRKeyword=pityriasis rosea
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 19:31, 15 March 2014
Author [[PageAuthor::Vidit Bhargava, M.B.B.S [1]]]
Exam Type ExamType::USMLE Step 2 CK
Main Category
Sub Category SubCategory::Dermatology
Prompt [[Prompt::A 30 yr old male presents to the clinic with an erythematous, pruritic rash as shown below. The rash spares palms and soles, but involves the back and chest. What is the best treatment strategy at this point?

]]

Answer A AnswerA::Observe, as it is a self limiting condition.
Answer A Explanation AnswerAExp::The condition is pityriasis rosea, which is a self limiting condition which usually resolves within 6-8 weeks. Hence, watchful observation is the best treatment strategy which can be followed by steroids if needed.
Answer B [[AnswerB::Prescribe a topical high potency steroid.]]
Answer B Explanation AnswerBExp::The condition usually requires no treatment unless the rash is severely itchy. In such a case a topical steroid may be prescribed for a short duration.
Answer C AnswerC::Prescribe oral steroids for 4 weeks and gradually taper.
Answer C Explanation AnswerCExp::Oral steroids are usually not required to treat pityriasis rosea.
Answer D AnswerD::Prescribe antifungals such as terbinafine, Itraconazole.
Answer D Explanation [[AnswerDExp::These antifungals are needed to treat pityriasis versicolor that is caused by fungus Malassezia furfur. Antifungals have no role in the treatment of pityriasis rosea.]]
Answer E [[AnswerE::Single intramuscular dose of Benzathine Penicillin.]]
Answer E Explanation [[AnswerEExp::It is the drug of choice for secondary syphilis, which is one of the chief medical conditions which need to be differentiated when considering a diagnosis of pityriasis rosea.]]
Right Answer RightAnswer::A
Explanation [[Explanation::Pityriasis rosea usually requires no treatment. In cases when the lesions are severely itchy, topical high potency steroids may be used. Oral steroids are almost never needed for treatment. Some cases may be benefited by UV light treatment.

Educational Objective: It is a self limiting condition, requiring treatment with topical steroids only when severe manifestations are present.
References: Page 101 FA STEP2CK seventh edition]]

Approved Approved::Yes
Keyword WBRKeyword::pityriasis rosea
Linked Question Linked::
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