A 42-year-old man with chronic plaque psoriasis, well controlled for a year, develops a sudden widespread flare. He was recently started on treatment for hypertension and has stable bipolar disorder. Which of his medications is the most likely precipitant?
- A Amlodipine
- B Metformin
- C Metoprolol ✓
- D Levothyroxine
Correct answer: C. Metoprolol
Explanation
Beta blockers are classic inducers and exacerbators of psoriasis; they may also provoke pustular lesions. Other well-documented culprit drugs include lithium, antimalarials, NSAIDs, ACE inhibitors, and terbinafine. Lithium is relevant given his bipolar disorder, but among the listed options only metoprolol is a beta blocker. Dihydropyridine calcium channel blockers such as amlodipine, metformin, and levothyroxine are not recognized psoriasis triggers.
Reference: Rook's Textbook of Dermatology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.