Post-Inflammatory Hyperpigmentation — SCE Dermatology MCQ

Correct answer: D — Topical agents containing azelaic acid, retinoids, vitamin C, or hydroquinone (used cautiously) can accelerate PIH resolution; strict sunscreen use prevents darkening

The best answer is “Topical agents containing azelaic acid, retinoids, vitamin C, or hydroquinone (used cautiously) can accelerate PIH resolution; strict sunscreen use prevents darkening”. Eczema treatment is selected by site and severity, with topical corticosteroid or calcineurin-inhibitor safety, infection, adherence, contact allergy and psychosocial effects considered before escalation. The alternatives “Aggressive chemical peel, when the full phenotype supports it, within an appropriate UK pathway, after clinicopathological correlation, after specialist assessment”, “No treatment available — it is permanent, within an appropriate UK pathway, after clinicopathological correlation, after specialist assessment, when the full phenotype supports it”, “Cryotherapy to the pigmented areas, after clinicopathological correlation, after specialist assessment, when the full phenotype supports it, within an appropriate UK pathway”, “Bleaching cream at maximum strength, 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 CG57 atopic eczema recommendations: https://www.nice.org.uk/guidance/cg57/chapter/Recommendations