Rosh Pediatrics Practice Exam

What is the management approach for a suspected case of pityriasis rosea in a 16-year-old with a moderately itchy rash?

1. First-generation cephalosporins

2. Systemic glucocorticoids

3. Topical antifungals

4. Topical corticosteroids

The correct answer is: Topical corticosteroids

In the case of a suspected pityriasis rosea, the management primarily focuses on alleviating the symptoms rather than treating the condition itself, as pityriasis rosea is typically self-limiting. The rash is often itchy, and the use of topical corticosteroids is effective in providing symptomatic relief. They work by reducing inflammation and itching, making them a suitable first-line option for symptomatic treatment. While pityriasis rosea generally does not require aggressive treatment, it can be uncomfortable due to its itchiness, particularly in adolescents. Topical corticosteroids help to soothe the affected skin, facilitating comfort during the healing process. Other management options listed, such as first-generation cephalosporins and systemic glucocorticoids, are not appropriate, as these do not address the nature of pityriasis rosea, which is not caused by a bacterial infection or severe inflammation requiring systemic intervention. Topical antifungals are also not indicated in this scenario, as the condition is viral rather than fungal, and antifungal treatments would not provide the needed relief from itching associated with this rash.