Psoriasis — SCE Dermatology MCQ

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ModerateInflammatory DermatosesPsoriasisSCE Dermatology

A 40-year-old woman with chronic plaque psoriasis controlled on a biologic develops new plaque psoriasis on the scalp only, while body disease remains clear. What is this pattern called?

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Correct answer: B — Partial response with residual disease at a treatment-resistant site

This pattern is partial response with residual disease at a treatment-resistant site. The biologic is still effective overall because the body disease remains clear; the only active psoriasis is confined to the scalp, a high-impact/special site that can be difficult to treat and may persist despite otherwise good systemic control. This is not complete treatment failure, secondary loss of response, paradoxical psoriasis, or biologic allergy.

Reference: British Association of Dermatologists guidelines for biologic therapy for psoriasis 2023: a pragmatic update. British Journal of Dermatology, 2023. https://academic.oup.com/bjd/article/190/2/270/7280929