The Confusion between Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis as a Cause of Exfoliative Dermatitis: A Case Report
Background: Pustular psoriasis and Acute Generalized Exanthematous Pustulosis (AGEP) are grouped under pustular diseases, in which their clinical manifestations are similar. Those diseases can lead to exfoliative dermatitis. Purpose:To evaluate a specific histopathological examination in differentia...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | Indonesian |
| Published: |
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga
2021-11-01
|
| Series: | Berkala Ilmu Kesehatan Kulit dan Kelamin (Periodical of Dermatology and Venerology) |
| Subjects: | |
| Online Access: | https://e-journal.unair.ac.id/BIKK/article/view/18288 |
| _version_ | 1797506032535076864 |
|---|---|
| author | Desiana Widityaning Sari Damayanti Damayanti Sylvia Anggraeni Menul Ayu Umborowati Evy Ervianti |
| author_facet | Desiana Widityaning Sari Damayanti Damayanti Sylvia Anggraeni Menul Ayu Umborowati Evy Ervianti |
| author_sort | Desiana Widityaning Sari |
| collection | DOAJ |
| description | Background: Pustular psoriasis and Acute Generalized Exanthematous Pustulosis (AGEP) are grouped under pustular diseases, in which their clinical manifestations are similar. Those diseases can lead to exfoliative dermatitis. Purpose:To evaluate a specific histopathological examination in differentiating Pustular Psoriasis and AGEP. Case: A 55-year-old woman presented with sudden redness and diffused scaly skin with multiple pustules and also fever. She had taken Cefadroxil 2 days before the scales and pustules appeared. Leukocytosis and histopathological examination results from biopsy supported the diagnosis of AGEP. The patient was then hospitalized and received steroid therapy. Within the first week of tapering off, the scales disappeared but the pustules increased. After such clinical findings, the histopathological examination results were revisited and reassessed. Thus, we considered changing the diagnosis to Pustular Psoriasis, and the therapy was switched to Methotrexate. The patient had a better outcome, and the pustules slowly disappeared entirely. Discussion: It is often difficult to differentiate between the pustules in pustular psoriasis and AGEP unless by thorough history-taking and physical examinations. AGEP is characterized by a widespread of pustules with an acute febrile onset; while pustular psoriasis is an acute variant of psoriasis where pustules are spread over erythematous skin and accompanied by high fever and leukocytosis. Conclusion: Histopathological examination is the gold standard for the establishment of pustular psoriasis diagnosis. The histopathological characteristics of pustular psoriasis and AGEP are difficult to differentiate. Therefore, we need detailed history-taking and physical examination to establish the diagnosis. |
| first_indexed | 2024-03-10T04:26:49Z |
| format | Article |
| id | doaj.art-70b9a969e90041d39f75b194378f943c |
| institution | Directory Open Access Journal |
| issn | 1978-4279 2549-4082 |
| language | Indonesian |
| last_indexed | 2024-03-10T04:26:49Z |
| publishDate | 2021-11-01 |
| publisher | Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga |
| record_format | Article |
| series | Berkala Ilmu Kesehatan Kulit dan Kelamin (Periodical of Dermatology and Venerology) |
| spelling | doaj.art-70b9a969e90041d39f75b194378f943c2023-11-23T06:34:49ZindDepartment of Dermatology and Venereology, Faculty of Medicine, Universitas AirlanggaBerkala Ilmu Kesehatan Kulit dan Kelamin (Periodical of Dermatology and Venerology)1978-42792549-40822021-11-0133322423110.20473/bikk.V33.3.2021.224-23114944The Confusion between Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis as a Cause of Exfoliative Dermatitis: A Case ReportDesiana Widityaning Sari0Damayanti Damayanti1Sylvia Anggraeni2Menul Ayu Umborowati3Evy Ervianti4Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, SurabayaDepartment of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, SurabayaDepartment of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, SurabayaDepartment of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, SurabayaDepartment of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, SurabayaBackground: Pustular psoriasis and Acute Generalized Exanthematous Pustulosis (AGEP) are grouped under pustular diseases, in which their clinical manifestations are similar. Those diseases can lead to exfoliative dermatitis. Purpose:To evaluate a specific histopathological examination in differentiating Pustular Psoriasis and AGEP. Case: A 55-year-old woman presented with sudden redness and diffused scaly skin with multiple pustules and also fever. She had taken Cefadroxil 2 days before the scales and pustules appeared. Leukocytosis and histopathological examination results from biopsy supported the diagnosis of AGEP. The patient was then hospitalized and received steroid therapy. Within the first week of tapering off, the scales disappeared but the pustules increased. After such clinical findings, the histopathological examination results were revisited and reassessed. Thus, we considered changing the diagnosis to Pustular Psoriasis, and the therapy was switched to Methotrexate. The patient had a better outcome, and the pustules slowly disappeared entirely. Discussion: It is often difficult to differentiate between the pustules in pustular psoriasis and AGEP unless by thorough history-taking and physical examinations. AGEP is characterized by a widespread of pustules with an acute febrile onset; while pustular psoriasis is an acute variant of psoriasis where pustules are spread over erythematous skin and accompanied by high fever and leukocytosis. Conclusion: Histopathological examination is the gold standard for the establishment of pustular psoriasis diagnosis. The histopathological characteristics of pustular psoriasis and AGEP are difficult to differentiate. Therefore, we need detailed history-taking and physical examination to establish the diagnosis.https://e-journal.unair.ac.id/BIKK/article/view/18288psoriasis pustulosaagephistopathological examhuman and diseaseination |
| spellingShingle | Desiana Widityaning Sari Damayanti Damayanti Sylvia Anggraeni Menul Ayu Umborowati Evy Ervianti The Confusion between Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis as a Cause of Exfoliative Dermatitis: A Case Report Berkala Ilmu Kesehatan Kulit dan Kelamin (Periodical of Dermatology and Venerology) psoriasis pustulosa agep histopathological exam human and disease ination |
| title | The Confusion between Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis as a Cause of Exfoliative Dermatitis: A Case Report |
| title_full | The Confusion between Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis as a Cause of Exfoliative Dermatitis: A Case Report |
| title_fullStr | The Confusion between Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis as a Cause of Exfoliative Dermatitis: A Case Report |
| title_full_unstemmed | The Confusion between Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis as a Cause of Exfoliative Dermatitis: A Case Report |
| title_short | The Confusion between Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis as a Cause of Exfoliative Dermatitis: A Case Report |
| title_sort | confusion between pustular psoriasis and acute generalized exanthematous pustulosis as a cause of exfoliative dermatitis a case report |
| topic | psoriasis pustulosa agep histopathological exam human and disease ination |
| url | https://e-journal.unair.ac.id/BIKK/article/view/18288 |
| work_keys_str_mv | AT desianawidityaningsari theconfusionbetweenpustularpsoriasisandacutegeneralizedexanthematouspustulosisasacauseofexfoliativedermatitisacasereport AT damayantidamayanti theconfusionbetweenpustularpsoriasisandacutegeneralizedexanthematouspustulosisasacauseofexfoliativedermatitisacasereport AT sylviaanggraeni theconfusionbetweenpustularpsoriasisandacutegeneralizedexanthematouspustulosisasacauseofexfoliativedermatitisacasereport AT menulayuumborowati theconfusionbetweenpustularpsoriasisandacutegeneralizedexanthematouspustulosisasacauseofexfoliativedermatitisacasereport AT evyervianti theconfusionbetweenpustularpsoriasisandacutegeneralizedexanthematouspustulosisasacauseofexfoliativedermatitisacasereport AT desianawidityaningsari confusionbetweenpustularpsoriasisandacutegeneralizedexanthematouspustulosisasacauseofexfoliativedermatitisacasereport AT damayantidamayanti confusionbetweenpustularpsoriasisandacutegeneralizedexanthematouspustulosisasacauseofexfoliativedermatitisacasereport AT sylviaanggraeni confusionbetweenpustularpsoriasisandacutegeneralizedexanthematouspustulosisasacauseofexfoliativedermatitisacasereport AT menulayuumborowati confusionbetweenpustularpsoriasisandacutegeneralizedexanthematouspustulosisasacauseofexfoliativedermatitisacasereport AT evyervianti confusionbetweenpustularpsoriasisandacutegeneralizedexanthematouspustulosisasacauseofexfoliativedermatitisacasereport |