In the management of erythrodermic psoriasis, which of the following systemic agents is CONTRAINDICATED due to risk of precipitating flare after withdrawal?
- A Acitretin
- B Systemic corticosteroids ✓
- C Cyclosporine
- D Methotrexate
Correct answer: B. Systemic corticosteroids
Explanation
Systemic corticosteroids are contraindicated in psoriasis — particularly erythrodermic and pustular psoriasis — because rapid withdrawal after initial improvement triggers a severe rebound flare that can be life-threatening (conversion to pustular psoriasis). Acitretin (retinoid), cyclosporine, and methotrexate are the recommended systemic agents for erythrodermic psoriasis. Biologics (anti-TNF, anti-IL17, anti-IL23) are alternatives in refractory cases.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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