Subcorneal pustular dermatosis: Clinical characteristics and long-term follow-up of seventeen patients

Background/Aim. Subcorneal pustular dermatosis (SPD) is a rare, relapsing vesiculopustular disease predominantly presenting on the flexor surfaces. Since data about the course and duration of the disease is limited, the aim of the study was to analyze the clinical features and long-term follow-up da...

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Main Authors: Radević Tatjana, Mijušković Željko P., Kandolf Lidija
Format: Article
Language:English
Published: Military Health Department, Ministry of Defance, Serbia 2024-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:https://doiserbia.nb.rs/img/doi/0042-8450/2024/0042-84502300064R.pdf
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author Radević Tatjana
Mijušković Željko P.
Kandolf Lidija
author_facet Radević Tatjana
Mijušković Željko P.
Kandolf Lidija
author_sort Radević Tatjana
collection DOAJ
description Background/Aim. Subcorneal pustular dermatosis (SPD) is a rare, relapsing vesiculopustular disease predominantly presenting on the flexor surfaces. Since data about the course and duration of the disease is limited, the aim of the study was to analyze the clinical features and long-term follow-up data on patients with SPD. Methods. A hospital database was searched for medical records of patients with SPD hospitalized at the institution between 1985 and 2014. The focus was on clinical characteristics, associated diseases, disease courses, and outcomes. Results. Seventeen patients with clinical features of SPD were analyzed – nine females and eight males with a median age at presentation of 45 years (range 18–90 years). Follow-up data were available for 12 patients. The median follow-up time was 9.5 years (1–28 years). In order to establish a histological diagnosis, repeated biopsies were required (on average 1.7 biopsies per patient). In one male patient, IgA pemphigus was diagnosed by direct immunofluorescence. In most patients, skin eruption was widespread, while in a smaller number of patients, the changes were present only on the flexor surfaces. Dysproteinemia was evident in three patients. The disease was self-limiting in three patients; five patients had mild flare-ups occurring 1–3 times a year without the need for treatment; four patients had continuous flare-ups requiring treatment. Most patients with SPD responded positively to dapsone. Conclusion. SPD is a rare disease, and it usually occurs in a person’s fifth decade. While it is self-limiting in some patients, approximately one-third of patients require continuous therapy for continuous flare-ups.
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spelling doaj.art-6058ffa8a2f14677b955c15821cc200b2024-04-10T10:28:45ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202024-01-0181211111610.2298/VSP230830064R0042-84502300064RSubcorneal pustular dermatosis: Clinical characteristics and long-term follow-up of seventeen patientsRadević Tatjana0https://orcid.org/0000-0001-9259-3031Mijušković Željko P.1https://orcid.org/0000-0003-0924-1719Kandolf Lidija2https://orcid.org/0000-0002-5221-5068Military Medical Academy, Department of Dermatology and Venereology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Department of Dermatology and Venereology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Department of Dermatology and Venereology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaBackground/Aim. Subcorneal pustular dermatosis (SPD) is a rare, relapsing vesiculopustular disease predominantly presenting on the flexor surfaces. Since data about the course and duration of the disease is limited, the aim of the study was to analyze the clinical features and long-term follow-up data on patients with SPD. Methods. A hospital database was searched for medical records of patients with SPD hospitalized at the institution between 1985 and 2014. The focus was on clinical characteristics, associated diseases, disease courses, and outcomes. Results. Seventeen patients with clinical features of SPD were analyzed – nine females and eight males with a median age at presentation of 45 years (range 18–90 years). Follow-up data were available for 12 patients. The median follow-up time was 9.5 years (1–28 years). In order to establish a histological diagnosis, repeated biopsies were required (on average 1.7 biopsies per patient). In one male patient, IgA pemphigus was diagnosed by direct immunofluorescence. In most patients, skin eruption was widespread, while in a smaller number of patients, the changes were present only on the flexor surfaces. Dysproteinemia was evident in three patients. The disease was self-limiting in three patients; five patients had mild flare-ups occurring 1–3 times a year without the need for treatment; four patients had continuous flare-ups requiring treatment. Most patients with SPD responded positively to dapsone. Conclusion. SPD is a rare disease, and it usually occurs in a person’s fifth decade. While it is self-limiting in some patients, approximately one-third of patients require continuous therapy for continuous flare-ups.https://doiserbia.nb.rs/img/doi/0042-8450/2024/0042-84502300064R.pdfbiopsydapsonediagnosisimmunohistochemistryskin diseases, vesiculobulloustreatment outcome
spellingShingle Radević Tatjana
Mijušković Željko P.
Kandolf Lidija
Subcorneal pustular dermatosis: Clinical characteristics and long-term follow-up of seventeen patients
Vojnosanitetski Pregled
biopsy
dapsone
diagnosis
immunohistochemistry
skin diseases, vesiculobullous
treatment outcome
title Subcorneal pustular dermatosis: Clinical characteristics and long-term follow-up of seventeen patients
title_full Subcorneal pustular dermatosis: Clinical characteristics and long-term follow-up of seventeen patients
title_fullStr Subcorneal pustular dermatosis: Clinical characteristics and long-term follow-up of seventeen patients
title_full_unstemmed Subcorneal pustular dermatosis: Clinical characteristics and long-term follow-up of seventeen patients
title_short Subcorneal pustular dermatosis: Clinical characteristics and long-term follow-up of seventeen patients
title_sort subcorneal pustular dermatosis clinical characteristics and long term follow up of seventeen patients
topic biopsy
dapsone
diagnosis
immunohistochemistry
skin diseases, vesiculobullous
treatment outcome
url https://doiserbia.nb.rs/img/doi/0042-8450/2024/0042-84502300064R.pdf
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AT mijuskoviczeljkop subcornealpustulardermatosisclinicalcharacteristicsandlongtermfollowupofseventeenpatients
AT kandolflidija subcornealpustulardermatosisclinicalcharacteristicsandlongtermfollowupofseventeenpatients