WBR1002

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Author [[PageAuthor::Vidit Bhargava, M.B.B.S [1]]]
Exam Type ExamType::USMLE Step 2 CK
Main Category MainCategory::Internal medicine
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?

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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.
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 Mallassezia
Answer E AnswerE::Single intramuscular dose of Benzathine Penicillin.
Answer E Explanation AnswerEExp::It is the drug of choice for secondary syphilis.
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.
Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::pityriasis rosea
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