COVID vaccine‐induced pustular psoriasis in patients with previous plaque type psoriasis

Background: Pustular psoriasis is an uncommon form of psoriasis that often affects areas of the hands and feet. It typically manifests as small pustules that develop within erythematous areas of the palms and soles. Infliximab, a tumor necrosis factor inhibitor, can be used to treat pustular psoriasis. Infliximab can also be effective in the treatment of various other disorders, including plaque-type psoriasis, psoriatic arthritis, Crohn disease, rheumatoid arthritis, and ankylosing spondylitis. Objective: We present a case of a young woman developing pustular psoriasis for the first time despite being on infliximab treatment for Crohn disease. Results: Infliximab has been successful in the treatment of pustular psoriasis. In rare cases, plaque psoriasis appears for the first time during infliximab treatment for other disorders, such as Crohn disease. Conclusion: Plantar pustular psoriasis occurring for the first time during infliximab treatment is an uncommon occurrence.

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A Case of Ceftriaxone-Induced Acute Generalized Exanthematous Pustulosis/Generalized Pustular Psoriasis Overlap

Case Reports in Dermatology ◽

10.1159/000488076 ◽

2018 ◽

Vol 10 (1) ◽

pp. 69-75 ◽

Cited By ~ 2

Author(s):

Jianfeng Zheng ◽

Yunlu Gao ◽

Xuemei Yi ◽

Yangfeng Ding

Keyword(s):

Pustular Psoriasis ◽

Whole Body ◽

Complete Regression ◽

Clinical Form ◽

Acute Generalized Exanthematous Pustulosis ◽

Plaque Type ◽

Generalized Pustular Psoriasis ◽

History Of ◽

Exanthematous Pustulosis ◽

Missense Substitution

Acute generalized exanthematous pustulosis, characterized by subcorneal or superficial intraepidermal pustules, is induced by drugs in more than 90% of cases. Psoriasis is an autoimmune disease triggered by different conditions in genetically susceptible people. Generalized pustular psoriasis is an acute and severe clinical form of psoriasis, which usually occurs in patients with psoriasis undergoing aggravating factors. In this report the authors have reported a 40-year-old male patient with primary syphilis who developed generalized pustular dermatosis after the use of ceftriaxone. On the third day after ceftriaxone treatment, complete regression of the syphilis lesions was reached. While on the sixth day, erythematous pustular lesions accompanied with fever were observed on the whole body. A personal history of psoriasis and histopathological findings with psoriasiform changes and subcorneal pustule favored the diagnosis. After discontinuation of ceftriaxone, the patient’s condition slowly improved until he had plaque-type psoriasis 3 weeks later. A heterozygous c.115 + 6T>C missense substitution of IL36RN related to the pathogenesis of acute generalized exanthematous pustulosis/generalized pustular psoriasis was identified.

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