Only definitive indication of systemic steroids in psoriasis is?

Ans. is 'b' i.e., Pregnancy associated pustular psoriasis * Treatment of choice for generalized pustular psoriasis of pregnancy (impetigo herpatiformis) is systemic steroids.* Systemic corticosteroids may prolong generalized pustular psoriasis and erythrodermic psoriasis (erythroderma) and abrupt withdrawal of corticosteroids can precipitate both theseSystemic corticosteroids in psoriasis* The place of systemic corticosteroids therapy in the management of psoriasis is limited not only by their well known side effect profile, but also by the risk of rebound flaring of psoriasis which may result in life threatening erythroderma or generalized pustular psoriasis. It is therefore generally recommended that systemic corticosteroids should only be used for treating psoriasis in the following circumstances: -1. Generalized pustular psoriasis of pregnancy/erythroderma (only definitive indication2. Persistent, otherwise uncontrolled, erythrodermic psoriasis causing metabolic complications.3. Generalized pustular psoriasis if other drugs are contraindicated or ineffective.4. Severe psoriatic polyarthritis threatening severe irreversible joint damage (not in mild or moderate arthritis).5. If systemic steroids is to be employed long term in the management of psoriasis, deflazacort rather than prednisolone should be used. They must be withdrawn slowly to minimize risk of rebound.