title: A Case of Acute Generalized Pustular Psoriasis of von Zumbusch Triggered by Hypocalcemia.
abstract: Psoriasis is an autoimmune disease triggered by different conditions in genetically susceptible people. It is characterized by variable cutaneous manifestations including localized or disseminated pustules. Generalized pustular psoriasis (GPP) has two main clinical forms: von Zumbusch psoriasis, characterized by severe erythrodermia and scaling skin after the resolution of pustules, and the annular form. GPP may also present severe extracutaneous manifestations including pneumonitis, heart failure and hepatitis. Old reports showed a relationship between hypoparathyroidism and hypocalcemia as triggers for GPP highlighting the importance of adequate workup of the patient and possible therapeutic changes in acute situations. Here, we present a case of severe von Zumbusch psoriasis with life-threatening complications triggered by severe hypocalcemia secondary to hypoparathyroidism successfully treated with aggressive calcium reposition.
authors.affiliation: Programa de Residência de Clínica Médica do Hospital Santo Antônio, Obras Sociais Irmã Dulce, Brazil; Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil.
authors.forename: Carlos Antônio Gusmão
authors.initials: CA
authors.lastname: Guerreiro de Moura
authors.affiliation: Programa de Residência de Clínica Médica do Hospital Santo Antônio, Obras Sociais Irmã Dulce, Brazil.
authors.forename: Luiz Henrique
authors.initials: LH
authors.lastname: de Assis
authors.affiliation: Programa de Residência de Clínica Médica do Hospital Santo Antônio, Obras Sociais Irmã Dulce, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Góes
authors.affiliation: Faculdade de Medicina da UNIFENAS, Alfenas, Brazil.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Rosa
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil.
authors.forename: Victor
authors.initials: V
authors.lastname: Nunes
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil.
authors.forename: Ítalo Magalhães
authors.initials: ÍM
authors.lastname: Gusmão
authors.affiliation: Programa de Residência de Clínica Médica do Hospital Santo Antônio, Obras Sociais Irmã Dulce, Brazil; Curso de Pós-graduação em Medicina e Saúde Humana da Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil.
authors.forename: Constança Margarida Sampaio
authors.initials: CM
authors.lastname: Cruz
keywords: Hypocalcemia; Hypoparathyroidism; Psoriasis; Psoriasis of von Zumbusch