scholarly journals Elderly-Onset Generalized Pustular Psoriasis without a Previous History of Psoriasis Vulgaris

2015 ◽  
Vol 7 (2) ◽  
pp. 187-193 ◽  
Author(s):  
Takayuki Aizu ◽  
Akinobu Matsui ◽  
Noriko Takiyoshi ◽  
Eijiro Akasaka ◽  
Takahide Kaneko ◽  
...  
Keyword(s):  
Psoriasis Vulgaris ◽  
Clinical Course ◽  
Previous History ◽  
Neutrophil Infiltration ◽  
Skin Lesions ◽  
Pustular Psoriasis ◽  
Whole Body ◽  
Older Individuals ◽  
Generalized Pustular Psoriasis ◽  
History Of

Generalized pustular psoriasis (GPP) is characterized by sudden fever and extensive erythema with pustules and occurs in patients with or without preceding psoriasis vulgaris. We report an 83-year-old man showing irregularly shaped erythema with pustules on the trunk and extremities. He initially had no fever and came to our clinic a few days after the onset of the skin lesions because of high fever and general malaise. We found an extension and new development of erythema and pustules on the whole body. The patient also manifested night delirium. Histological examination revealed neutrophil infiltration into the upper epidermis, which formed a spongiform pustule of Kogoj. Pustular fluid cultures were negative for bacteria. We diagnosed GPP without preceding psoriasis vulgaris. Mutation analysis revealed no significant mutations in IL36RN and CARD14. Previous reports indicated that onset of GPP at the age of 83 years is definitely rare. In older individuals, general disease characteristics include an atypical clinical course, an especially slow appearance and cure, and mental disorder. Our case also revealed such characteristics. Thus, it is necessary to be aware of the clinical course and mental problems in elderly patients with GPP.

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

2018 ◽  
Vol 10 (1) ◽  
pp. 69-75 ◽  
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.

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

scholarly journals A Case of Old Age-Onset Generalized Pustular Psoriasis with a Deficiency of IL-36RN (DITRA) Treated by Granulocyte and Monocyte Apheresis

2015 ◽  
Vol 7 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Chiharu Tominaga ◽  
Masaaki Yamamoto ◽  
Yasutomo Imai ◽  
Kiyofumi Yamanishi
Keyword(s):  
Receptor Antagonist ◽  
Dose Reduction ◽  
Old Age ◽  
Psoriasis Vulgaris ◽  
Serum Levels ◽  
Pustular Psoriasis ◽  
Generalized Pustular Psoriasis ◽  
Homozygous Mutations ◽  
Inflammatory Infiltrates

A 78-year-old woman who had been suffering from psoriasis vulgaris for 31 years was admitted to hospital because of her erythroderma. A toxic eruption was suspected and she was treated with prednisolone 30 mg daily. However, it was ineffective and, suspecting psoriatic erythroderma, cyclosporine 150 mg daily was administered with tapering of the prednisolone. Two weeks after a dose reduction of cyclosporine to 100 mg/day, erythroderma with widespread generalized pustules and fever developed. Histology of a biopsy revealed inflammatory infiltrates in the skin with a spongiform pustule of Kogoj, which was consistent with generalized pustular psoriasis (GPP). Her pustules improved with additional etretinate 20 mg/day, but the erythroderma persisted and she consulted us. Three sessions of granulocyte and monocyte apheresis once weekly were effective for her condition and decreased her serum levels of IL-6 and IL-8. She had homozygous mutations of c.[28C>T] in IL36RN which cause p.[Arg10Ter]. She is the oldest reported case of GPP with a deficiency of interleukin-36 receptor antagonist (DITRA), although GPP in DITRA has been suggested to usually occur in younger cases with no pre-existing psoriasis vulgaris.

scholarly journals Anti-laminin-gamma 1 Pemphigoid with Generalized Pustular Psoriasis and Psoriasis Vulgaris

2016 ◽  
Vol 96 (1) ◽  
pp. 120-121 ◽  
Author(s):  
Y Fujimura ◽  
K Natsuga ◽  
Y Hamade ◽  
Y Nomura ◽  
Y Kaku ◽  
...  
Keyword(s):  
Psoriasis Vulgaris ◽  
Pustular Psoriasis ◽  
Generalized Pustular Psoriasis

A case of generalized pustular psoriasis caused by hydroxychloroquine in a patient with systemic lupus erythematosus

Lupus ◽  
2019 ◽  
Vol 28 (8) ◽  
pp. 1017-1020 ◽  
Author(s):  
E Shindo ◽  
K Shikano ◽  
M Kawazoe ◽  
T Yamamoto ◽  
N Kusunoki ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Neutrophil Infiltration ◽  
Pustular Psoriasis ◽  
Nucleotide Polymorphisms ◽  
Systemic Lupus ◽  
Single Nucleotide ◽  
Potential Development ◽  
Generalized Pustular Psoriasis ◽  
The Face

Hydroxychloroquine (HCQ) has been used to treat systemic lupus erythematosus (SLE) in Japan since 2015. We herein report a case of SLE that developed generalized pustular psoriasis (GPP) following the administration of HCQ. Twenty-one days after the HCQ treatment, a pustular rash with itching appeared on the auricle, scalp, and forearm, and spread rapidly to the face and body trunk with a high fever and arthralgia. Skin biopsy showed pustule formation under the cornified layer, neutrophil infiltration, the destruction of keratinocytes, and spongiform pustules of Kogoj. The patient was diagnosed with GPP. HCQ was immediately discontinued, the dose of prednisolone (PSL) was increased, and granulocyte and monocyte adsorption apheresis was performed. Her symptoms subsequently disappeared. Since arthralgia relapsed after the tapering of PSL, cyclosporine was added. Although single nucleotide polymorphisms (c.28C>T and c.115+6T>C) in the interleukin (IL)-36RN gene, which encodes the IL-36 receptor antagonist, have frequently been reported in GPP, these mutations were not observed in the present case. The potential development of GPP needs to be considered when administering HCQ to patients with SLE.

scholarly journals Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1004
Author(s):  
Morgan Sussman ◽  
Anthony Napodano ◽  
Simo Huang ◽  
Abhirup Are ◽  
Sylvia Hsu ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Clinical Course ◽  
Pustular Psoriasis ◽  
Topical Steroids ◽  
Inflammatory Disorder ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Cutaneous Adverse Reaction ◽  
History Of ◽  
Exanthematous Pustulosis ◽  
Crucial Part

The similarity between pustular psoriasis (PP) and acute generalized exanthematous pustulosis (AGEP) poses problems in the diagnosis and treatment of these two conditions. Significant clinical and histopathologic overlap exists between PP and AGEP. PP is an inflammatory disorder that has numerous clinical subtypes, but all with sterile pustules composed of neutrophils. AGEP is a severe cutaneous adverse reaction that is also characterized by non-follicular sterile pustules. Clinical features that suggest a diagnosis of PP over AGEP include a history of psoriasis and the presence of scaling plaques. Histologically, eosinophilic spongiosis, vacuolar interface dermatitis, and dermal eosinophilia favor a diagnosis of AGEP over PP. Importantly, PP and AGEP vary in clinical course and treatment. PP treatment involves topical steroids, oral retinoids, and systemic immunosuppressants. Newer therapies targeting IL-36, IL-23, IL-1, and PDE-4 have been investigated. The removal of the offending agent is a crucial part of the treatment of AGEP.

scholarly journals Essential syphilitic alopecia: Non-scarring alopecia in 21-year-old man

2021 ◽  
Vol 12 (e) ◽  
pp. 1-3
Author(s):  
Hafssa Chehab ◽  
Bertrand Richert
Keyword(s):  
Hair Loss ◽  
Previous History ◽  
Treponema Pallidum ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Laboratory Evaluation ◽  
History Of ◽  
High Level

ABSTRACT Alopecia syphilitica is a less common clinical manifestations of secondary syphilis. It is uncommon for hair loss to be the sole or predominant manifestation, as hair loss is the chief clinical and histologic differential diagnosis of. The main difference between alopecia areata and Alopecia syphilitica is the detection of Treponema pallidum in syphilis. We present the case of a 21- year-old belgium man with different patches of non-cicatricial alopecia of his scalp. The patient denied previous history of genital or other skin lesions. Laboratory evaluation was positive for syphilis. The diagnosis of alopecia syphilitica was made and he was treated with single intramuscular injections of benzathine penicillin. The lesions improved with treatment in all the patients who attended follow-up. Dermatologists should maintain a high level of clinical suspicion for this uncommon manifestation of syphilis, particularly when it is the only symptom.

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