skip to main content

Zopiclone in liver disease — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardRenal and Hepatic ImpairmentZopiclone in liver diseaseGPhC CRA

A patient used a potent topical corticosteroid daily on facial eczema for nine months. Five days after stopping, confluent burning erythema spreads beyond the treated area and feels different from, and worse than, the original eczema. Which diagnosis best accounts for this pattern?

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

Reveal the answer and explanation

Correct answer: C — A topical corticosteroid withdrawal reaction

A topical corticosteroid withdrawal reaction is characterised by intense confluent redness with burning or stinging, often extending beyond the original treatment area within days or weeks of stopping prolonged, frequent moderate-to-high-potency treatment. A simple eczema flare is more often itch-predominant and resembles the previous disease distribution. Contact allergy, infection and steroid-modified fungal disease remain differential diagnoses, but the timing and distinctive spreading burning erythema make withdrawal the best fit.

Reference: MHRA: Topical steroids and withdrawal reactions: https://www.gov.uk/drug-safety-update/topical-steroids-introduction-of-new-labelling-and-a-reminder-of-the-possibility-of-severe-side-effects-including-topical-steroid-withdrawal-reactions