Guttate Psoriasis — SCE Dermatology MCQ

Correct answer: E — There is limited evidence suggesting tonsillectomy may reduce recurrence in patients with recurrent streptococcal-triggered guttate psoriasis; it is considered in selected cases

The best answer is “There is limited evidence suggesting tonsillectomy may reduce recurrence in patients with recurrent streptococcal-triggered guttate psoriasis; it is considered in selected cases”. NICE recommends treatment matched to severity, high-impact sites, functional burden, comorbidity and prior response; narrowband UVB is a finite specialist option for plaque or guttate psoriasis that topical therapy cannot control. The alternatives “Tonsillectomy is indicated in psoriasis, after specialist assessment, when the full phenotype supports it, within an appropriate UK pathway, after clinicopathological correlation”, “Tonsillectomy is indicated, when the full phenotype supports it, within an appropriate UK pathway, after clinicopathological correlation, after specialist assessment”, “Tonsillectomy cures psoriasis permanently, within an appropriate UK pathway, after clinicopathological correlation, after specialist assessment, when the full phenotype supports it”, “Tonsillectomy is for children, after clinicopathological correlation, after specialist assessment, when the full phenotype supports it, within an appropriate UK pathway” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE CG153 psoriasis recommendations: https://www.nice.org.uk/guidance/cg153/chapter/Recommendations