Psoriasis — SCE Dermatology MCQ
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Correct answer: B — Coincidence
The dramatic improvement during a febrile upper respiratory tract infection is best explained as coincidence. Chronic plaque psoriasis is a relapsing–remitting immune-mediated disease whose severity can fluctuate spontaneously. Current dermatology guidance recognises infections as potential triggers or exacerbating factors for psoriasis, particularly streptococcal infection causing guttate psoriasis, and treats psoriasis with established topical therapy, phototherapy, systemic agents, or targeted biologics. Fever itself is not a recognised treatment, and there is no accepted clinical mechanism whereby a high core temperature reliably suppresses the Th17/IL-23 axis to induce psoriasis remission. Dehydration or improved medication efficacy during illness would not explain true inflammatory improvement.
Reference: American Academy of Dermatology–National Psoriasis Foundation. Psoriasis clinical guideline, current AAD guideline resource. https://www.aad.org/member/clinical-quality/guidelines/psoriasis