Question

Treatment of an erythematous skin rash with multiple pus lakes in a pregnant woman is:

• A. Corticosteroids
• B. Retinoids
• C. Methotrexate
• D. Psoralen with PUVA

Hint:

Pustular psoriasis of pregnancy needs a drug safe for the fetus.

Answer 1

The Correct Option is A

Step 1: An erythematous rash with multiple pus lakes in a pregnant woman points to impetigo herpetiformis, which is pustular psoriasis of pregnancy. It shows red plaques studded with small sterile pustules, often called pus lakes.
Step 2: This is a serious condition in pregnancy. It can cause fever, low calcium, and risk to the fetus, so it must be controlled quickly and safely.
Step 3: Systemic corticosteroids are the first line treatment because they are effective and acceptably safe in pregnancy. So option A is correct.
Step 4: Why the others are wrong. Retinoids are strong teratogens and are absolutely banned in pregnancy. Methotrexate is also teratogenic and an abortifacient, so it is contraindicated. PUVA uses psoralen, which is avoided in pregnancy and is not the safe first choice.
Step 5: So among the four, only corticosteroids are both effective and safe enough for a pregnant patient.
Answer: Corticosteroids.