Amicrobial pustular dermatosis in two patients with immunological abnormalities.
We report two patients with severe amicrobial pustular dermatosis with immunological abnormalities: a 63-year-old woman with a 30-year-history of discoid lupus erythematosus and sicca syndrome, and a 35-year-old woman with high levels of gamma-globulinemia and positive antinuclear antibodies. Both patients presented with crusty and eroded erythematous plaques studded with aseptic pustules on the back, face, and scalp. Histological examination showed acanthosis, neutrophilic exocytosis to the epidermis, and neutrophilic and lymphocytic infiltration with nuclear dust in the dermis. These patients were diagnosed as having "amicrobial pustulosis associated with autoimmune diseases". The eruptions improved with combination treatment of oral prednisolone with cyclosporin A or diaminodiphenylsulphone. Although the pathogenesis remains unclear, amicrobial pustular dermatosis might be one of the cutaneous complications in autoimmune diseases.
Kawasaki Hospital, Department of Dermatology, Okayama University Graduate School of Medicine and Dentistry, Okayama 719-0104, Japan. michiyo@po.harenet.ne.jp
M
M
Kuyama
W
W
Fujimoto
H
H
Kambara
M
M
Egusa
M
M
Saitoh
O
O
Yamasaki
K
K
Maehara
A
A
Ohara
J
J
Arata
K
K
Iwatsuki
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D016572:Cyclosporine / Q000627:therapeutic use; D003622:Dapsone / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use; D012872:Skin Diseases, Vesiculobullous / Q000150:complications / Q000188:drug therapy / Q000473:pathology*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D003879:Dermatologic Agents; D016572:Cyclosporine; D003622:Dapsone; D011239:Prednisolone