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?
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.
Coicosteroids
Retinoids
Methotrexate
Psoralen with PUVA