Anais Brasileiros de Dermatologia (Oct 2016)

Generalized pustular psoriasis induced by systemic steroid dose reduction

  • Danielle Cristine Westphal,
  • Antonio Pedro Mendes Schettini,
  • Petra Pereira de Souza,
  • Jessica Castiel,
  • Carlos Alberto Chirano,
  • Mônica Santos

DOI
https://doi.org/10.1590/abd1806-4841.20163804
Journal volume & issue
Vol. 91, no. 5
pp. 664 – 666

Abstract

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Abstract: Generalized pustular psoriasis, or psoriasis of von Zumbusch, is an acute and severe clinical form of psoriasis, which usually occurs in patients with psoriasis undergoing aggravating factors. In this work, we report the case of a female patient, 70 years old, who developed generalized pustular psoriasis symptoms while reducing the dose of oral corticosteroids, improperly introduced for the treatment of alleged acute generalized exanthematous pustulosis. The differential diagnosis of generalized pustular psoriasis should be made with other pustular dermatoses, such as subcorneal pustulosis, IgA pemphigus and especially with acute generalized exanthematous pustulosis. Personal history of psoriasis and histopathological findings with psoriasiform changes and subcorneal pustule favored the diagnosis. She was treated with acitretin 30 mg / day, progressing to complete regression of the lesions.

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