Atopic Eczema — SCE Dermatology MCQ

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ModerateDermatopharmacologyAtopic EczemaSCE Dermatology

A 18-year-old woman with atopic eczema has widespread eczema inadequately controlled with potent topical corticosteroids. She is commenced on Mycophenolate mofetil. What is the most important haematological monitoring requirement?

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Correct answer: A — Weekly full blood count for 4 weeks then monthly

Mycophenolate mofetil (MMF) requires close haematological monitoring as it can cause dose-dependent bone marrow suppression (leucopenia, anaemia, thrombocytopenia). BAD guidelines recommend weekly FBC for the first 4 weeks, then fortnightly for 2 months, then monthly thereafter. MMF is a prodrug of mycophenolic acid that inhibits inosine monophosphate dehydrogenase (IMPDH), blocking de novo purine synthesis in lymphocytes. It is teratogenic (pregnancy category X) and requires effective contraception. GI side effects (nausea, diarrhoea) are common and can be reduced by switching to enteric-coated mycophenolate sodium.

Reference: BAD 2018 Drug Monitoring Guidelines; BNF