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Venous Leg Ulcer — SCE Dermatology MCQ

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HardWound HealingVenous Leg UlcerSCE Dermatology

An adolescent taking ritlecitinib 50 mg daily has platelets 46×10⁹/L and absolute lymphocytes 0.8×10⁹/L on repeat testing. There is no bleeding or infection. Which product-information action is correct?

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

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Correct answer: A — Stop ritlecitinib below 50×10⁹/L and investigate other causes of thrombocytopenia

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

C is correct. The Litfulo SmPC directs discontinuation when platelets fall below 50×10⁹/L. The absolute lymphocyte count here remains above the 0.5×10⁹/L interruption threshold. Ritlecitinib is supplied and recommended as 50 mg once daily for alopecia areata; a 25-mg rescue regimen is not specified. Before starting, platelets must be at least 100×10⁹/L and ALC at least 0.5×10⁹/L, but the on-treatment action thresholds differ. The unexpected thrombocytopenia still needs clinical assessment for alternative causes and bleeding risk.

Reference: Litfulo 50 mg capsules Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/15257/smpc