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Dermatology · Papulosquamous disorders: topical therapy for an infant with severe atopic dermatitis
Sample itemAn 8-month-old with atopic dermatitis has weeping, crusted flexural eczema with honey-coloured crusts and yellow pustules. Which approach addresses the complicating factor together with the eczema?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Topical corticosteroid with an anti-staphylococcal antibiotic
Honey-coloured crusts signal secondary impetiginisation, usually Staphylococcus aureus. The skin needs an antibiotic along with a suitable-strength steroid and emollients.
Option by option
A. Oral isotretinoin
Isotretinoin is for acne and is contraindicated in an infant.
B. Potent topical corticosteroid alone on the face
A potent steroid alone on the face risks atrophy and leaves the infection untreated.
C. Systemic ciclosporin immediately
Ciclosporin is immunosuppressive and inappropriate while the skin is actively infected.
D. Topical corticosteroid with an anti-staphylococcal antibiotic (correct)
Correct. Infected eczema needs antibiotic cover as well as anti-inflammatory therapy.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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