Pustular psoriasis elicited by streptococcal antigen and localized to the sweat pore.
A woman, aged 39 years, presented with a localized, painful, pustular eruption of the neck, scalp, and finger of five years' duration. A diagnosis of pustular psoriasis was made clinically and histologically. It was possible to reproduce the disease by the intradermal injection of killed Group A streptococcal organisms. The induced pustules, as well as those appearing clinically, were intraepidermal and indistinguishable from the Kogoj spongiform abscess, and on serial sectioning showed a distinctive localization to the acryosyringium. Immunosuppressant as well as antistreptococcal therapy in the form of cyclophosphamide and clindamycin was of help. The process is classified as a nonvasculitic pustular bacterid, and as a prototype for antigen localization of lesions to the occluded epidermal sweat duct unit.
D000328:Adult; D000942:Antigens, Bacterial / Q000009:adverse effects; D002981:Clindamycin / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D007428:Intradermal Tests; D011565:Psoriasis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012874:Skin Diseases, Infectious; D013290:Streptococcal Infections / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000276:immunology; D013543:Sweat Gland Diseases / Q000209:etiology*
D000942:Antigens, Bacterial; D002981:Clindamycin; D003520:Cyclophosphamide