A 24 year old lady with a past history of psoriasis presents with fever and multiple pus filled lesions in a generalized distribution. What is the drug of choice?: (A) Coicosteroids, (B) Retinoids, (C) Methotrexate, (D) Psoralen with PUVA
Answer is C. The patient described in this question is suffering from generalized pustular psoriasis, also known as impetigo herpetiformis, if it occurs in pregnancy. Treatment of choice in generalized pustular psoriasis is Methotrexate except in pregnancy where it is systemic steroids. Ref: Obstetric Dermatology: A Practical Guide By Arieh Ingber, Mark Lebwohl, Page 139; Primary Care for Women By Phyllis Carolyn Leppe, Jeffrey F. Peipe, Page 849; Rooks Textbook of Dermatology, 8th Edition, Pages 20, 53.