skip to main content

Linear IgA Disease — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardPaediatric DermatologyLinear IgA DiseaseSCE Dermatology

A 7-year-old with severe atopic eczema develops fever and a rapidly spreading painful eruption of monomorphic vesicles and punched-out erosions. Several lesions involve the eyelid margin. A lesion swab for HSV PCR has been taken. What is the most appropriate initial plan?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Start systemic aciclovir and arrange same-day hospital and ophthalmology assessment

Explanation lettering: C = shown as B · E = shown as C · B = shown as E

B is correct. Fever, painful monomorphic vesicles and punched-out erosions in a child with eczema indicate eczema herpeticum. NICE advises immediate systemic aciclovir and same-day specialist advice rather than waiting for HSV confirmation. Eyelid involvement adds a risk of ocular herpes and requires same-day ophthalmological advice. A understates the urgency in a systemically unwell child with periocular disease. C delays antiviral therapy until PCR is available. D relies on topical antiviral treatment despite disseminated disease. E intensifies immunosuppression during a potentially serious viral infection.

Reference: NICE CG57 atopic eczema in under 12s recommendations: https://www.nice.org.uk/guidance/cg57/chapter/Recommendations