Treatment of choice in Pustular psoriasis –
**Core Concept**
Pustular psoriasis is a rare and severe form of psoriasis characterized by widespread pustules on the skin, often accompanied by systemic symptoms such as fever and malaise. The treatment of choice for pustular psoriasis aims to reduce inflammation, suppress the immune system, and prevent complications.
**Why the Correct Answer is Right**
The treatment of choice for pustular psoriasis is systemic corticosteroids, specifically methylprednisolone. This is because corticosteroids have potent anti-inflammatory properties that can quickly reduce the severity of pustules and alleviate systemic symptoms. Corticosteroids also have immunosuppressive effects, which can help to reduce the immune system's abnormal response in pustular psoriasis. The rapid onset of action of corticosteroids makes them an essential component of initial treatment.
**Why Each Wrong Option is Incorrect**
**Option A:** Phototherapy, such as ultraviolet B (UVB) light therapy, is not the first-line treatment for pustular psoriasis due to its slower onset of action and potential for exacerbating the condition in some cases.
**Option B:** Cyclosporine, an immunosuppressive medication, can be used as a second-line treatment for pustular psoriasis, but it is not the treatment of choice due to its potential side effects and the need for monitoring.
**Option C:** Acitretin, a retinoid medication, can be used to treat pustular psoriasis, but it is not the treatment of choice due to its slower onset of action and potential side effects.
**Clinical Pearl / High-Yield Fact**
In patients with pustular psoriasis, it is essential to monitor for signs of systemic involvement, such as fever, malaise, and leukocytosis, and to start treatment promptly to prevent complications.
**Correct Answer:** C. Cyclosporine.