Dermatology pp 697-708 | Cite as

Pustular Diseases

  • Otto Braun-Falco
  • Gerd Plewig
  • Helmut H. Wolff
  • Walter H. C. Burgdorf

Abstract

One unusual feature of the skin is its tendency to form sterile pustules. Nondermatologists have often been taught to equate pus with infection and find the nonchalance of dermatologists’ approach to pus puzzling. While many bacterial, viral, and fungal infections in the skin are indeed pustular, there are also many patients who present with sterile pustules. The prototypical pustular disease is psoriasis. Presumably, a number of noninfectious triggers can also produce the appropriate cytokines for eliciting a pustular response in the skin. In this chapter, we will discuss the idiopathic pustular diseases, dividing them as shown in Table 16.1 into acral and generalized conditions while also distinguishing between the childhood and adult forms.

Table 16.1

Idiopathic pustular diseases

Localizd acral pustules

Children

Infantile acropustulosis

 

Parakeratosis pustulosa

Adults

Acrodermatitis continua suppurativa

 

Palmoplantar pustulosis

 

Acute acropustulosis

 

Erosive pustular dermatosis

 

of the scalp

Generalized pustules

Children

Erythema toxicum neonatorum

 

Transient neonatal pustular melanosis

 

Incontinentia pigmenti

Adults

IgA pemphigus foliaceus

 

Subcorneal pustular dermatosis

 

Impetigo herpetiformis

 

Acute generalized exanthematous

 

pustulosis

 

Eosinophilic pustular folliculitis

Keywords

Vasculitis Glucagon Carbamazepine Colchicine Acne 

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Bibliography

Infantile Acropustulosis

  1. Dromy R, Raz A, Metzker A (1991) Infantile acropustulosis. Pediatr Dermatol 8: 284–287PubMedCrossRefGoogle Scholar
  2. Kahn G, Rywlin AM (1979) Acropustulosis of infancy. Arch Dermatol 115: 831–833PubMedCrossRefGoogle Scholar
  3. Mancini AJ, Frieden IJ, Palier AS (1998) Infantile acropustulosis revisited: history of scabies and response to topical corticosteroids. Pediatr Dermatol 15: 337–341PubMedCrossRefGoogle Scholar
  4. Newton JA, Salisbury J, Mardsen A et al. (1986) Acropustulosis of infancy. Br J Dermatol 115: 735–739PubMedCrossRefGoogle Scholar
  5. Van Praag MC, Van Rooij RW, Folkers E et al. (1997) Diagnosis and treatment of pustular disorders in the neonate. Pediatr Dermatol 14: 131–143PubMedCrossRefGoogle Scholar
  6. Vignon-Pennamen MD, Wallach D (1986) Infantile acropustulosis. A clinicopathologic study of six cases. Arch Dermatol 122: 1155–1160PubMedCrossRefGoogle Scholar

Parakeratosis Pustulosa

  1. Hjorth N, Thomsen K (1967) Parakeratosis pustulosa. Br J Dermatol 79: 527–532PubMedCrossRefGoogle Scholar
  2. Sabouraud R (1931) Les parakératoses microbiènnes du bouts des doigts. Ann Dermatol Syphil 11: 206Google Scholar
  3. Tosti A, Peluso AM, Zucchelli V et al. (1998) Clinical findings and long-term follow-up of 20 cases of parakeratosis pustulosa. Pediatr Dermatol 15: 259–263PubMedCrossRefGoogle Scholar

Acrodermatitis Continua Suppurativa

  1. Behrens S, von Kobyletzki G, Hoffmann K et al. (1997) PUVA-Bad-Photochemotherapie bei Acrodermatitis continua suppurativa Hallopeau. Hautarzt 48: 824–827PubMedCrossRefGoogle Scholar
  2. Hallopeau M (1890) Sur une asphyxie locale des extremities avec polydactylite suppurative chronique et pouseés epheméres dermatitae pustuleuse disséminée et symetrique. Bull Soc Fr Dermatol Syph 1: 39–45Google Scholar
  3. Kuijpers AL, van Dooren-Grebe RJ, van de Kerkhof PC (1996) Acrodermatitis continua of Hallopeau: response to combined treatment with acitretin and calcipotriol ointment. Dermatology 192: 357–359PubMedCrossRefGoogle Scholar
  4. Pearson LH, Allen BS, Smith JG Jr (1984) Acrodermatitis continua of Hallopeau: treatment with etretinate and review of relapsing pustular eruptions of the hands and feet. J Am Acad Dermatol 11: 755–762PubMedCrossRefGoogle Scholar
  5. Piraccini BM, Fanti PA, Morelli R et al. (1994) Hallopeau’s acrodermatitis continua of the nail apparatus: a clinical and pathological study of 20 patients. Acta Derm Venereol (Stockh) 74: 65–67Google Scholar

Palmoplantar Pustulosis

  1. Andrews GC, Birkman FW, Kelly RJ (1934) Recalcitrant pustular eruptions of the palms and soles. Arch Dermatol Syphil 29: 548–563CrossRefGoogle Scholar
  2. Burge SM, Ryan TJ (1985) Acute palmoplantar pustulosis. Br J Dermatol 113: 77–83PubMedCrossRefGoogle Scholar
  3. Eriksson MO, Hagforsen E, Lundin IP et al. (1998) Palmoplantar pustulosis: a clinical and immunohistological study. Br J Dermatol 138: 390–398PubMedCrossRefGoogle Scholar
  4. Lindelöf B, Beitner H (1990) The effect of grenzray therapy on pustulosis palmoplantaris. Acta Dermatol Venereol (Stockh) 70: 529–531Google Scholar
  5. Stevens DM, Ackerman BA (1984) On the concept of bacterids (pustular bacterid, Andrews). Am J Dermatopathol 6: 281–286PubMedCrossRefGoogle Scholar

Erosive Pustular Dermatosis of the Scalp

  1. Bieber T, Ruzicka T, Burg G (1987) Erosive pustulöse Dermatitis des Kapillitiums. Hautarzt 38: 687–689PubMedGoogle Scholar
  2. Caputo R, Veraldi S (1993) Erosive pustular dermatosis of the scalp. J Am Acad Dermatol 28: 96–98PubMedCrossRefGoogle Scholar
  3. Jacyk WK (1988) Pustular ulcerative dermatosis of the scalp. Br J Dermatol 118: 441–444PubMedCrossRefGoogle Scholar
  4. Pye RJ, Peachey RDG, Burton JL (1979) Erosive pustular dermatosis of the scalp. Br J Dermatol 100: 559–566PubMedCrossRefGoogle Scholar
  5. Watanabe S, Takizawa K, Hashimoto N et al. (1989) Pustular dermatosis of the scalp associated with autoimmune diseases. J Dermatol 16: 383–387PubMedGoogle Scholar

Erythema Toxicum Neonatorum

  1. Ferrandiz C, Coroleu W, Ribera M et al. (1992) Sterile transient neonatal pustulosis is a precocious form of erythema toxicum neonatorum. Dermatology 185: 18–22PubMedCrossRefGoogle Scholar
  2. Schwartz RA, Janniger CK (1996) Erythema toxicum neonatorum. Cutis 58: 153–155PubMedGoogle Scholar

Transient Neonatal Pustular Melanosis

  1. Hansen LP, Brandrup F, Zori R (1985) Erythema toxicum neonatorum mit Pustulation versus transitonische neonatale pustulöse Melanose. Hautarzt 36: 475–477PubMedGoogle Scholar
  2. Ramamurthy RS, Reveri M, Esterly NB et al. (1976) Transient neonatal pustular melanosis. J Pediatr 88: 831–835PubMedCrossRefGoogle Scholar
  3. Wyre HW, Murphy MO (1979) Transient neonatal pustular melanosis. Arch Dermatol 115: 458PubMedCrossRefGoogle Scholar

Transient Cephalic Neonatal Pustulosis

  1. Aractingi S, Cadranel S, Reygagne P et al. (1991) Neonatal pustulosis induced by Malassezia furfur. Ann Dermatol Venereol 118: 856–858PubMedGoogle Scholar
  2. Bardazzi F, Patrizi A (1997) Transient cephalic neonatal pustulosis. Arch Dermatol 133: 528–530PubMedCrossRefGoogle Scholar
  3. Niamba P, Weill FX, Sarlangue J (1998) Is common neonatal cephalic pustulosis (neonatal acne) triggered by Malassezia sympodialis? Arch Dermatol 134: 995–998PubMedCrossRefGoogle Scholar

Subcorneal Pustular Dermatosis

  1. Bauwens M, De Conick A, Roseeuw D (1999) Subcorneal pustular dermatosis treated with PUVA therapy. A case report and review of the literature. Dermatology 203–205Google Scholar
  2. Chimenti S, Ackerman AB (1981) Is subcorneal pustular dermatosis of Sneddon and Wilkinson an entity sui generis? Am J Dermatopathol 3: 363–376PubMedCrossRefGoogle Scholar
  3. Ise S, Ofuji S (1965) Subcorneal pustular dermatosis. A follicular variant? Arch Dermatol 92: 169–171CrossRefGoogle Scholar
  4. Kasha EE, Epinette WW (1988) Subcorneal pustular dermatosis (Sneddon-Wilkinson disease) in association with a monoclonal IgA-gammopathy: A report and review of the literature. J Am Acad Dermatol 19: 854–858PubMedCrossRefGoogle Scholar
  5. Lutz ME, Daoud MS, McEvoy MT et al. (1998) Subcorneal pustular dermatosis: a clinical study of ten patients. Cutis 61: 203–208PubMedGoogle Scholar
  6. Sneddon IB, Wilkinson DD (1956) Subcorneal pustular dermatosis. Br J Dermatol 68: 385–394PubMedCrossRefGoogle Scholar
  7. Sneddon IB, Wilkinson DS (1979) Subcorneal pustular dermatosis. Br J Dermatol 100: 61–68PubMedCrossRefGoogle Scholar
  8. Stolz W, Bieber T, Meurer M (1989) Its the atypical neutrophilic dermatosis with subcorneal IgA deposits a variant of pemphigus foliaceus? Br J Dermatol 120: 276–279CrossRefGoogle Scholar

Impetigo Herpetiformis

  1. Breier-Maly J, Ortel B, Breier F et al. (1999) Generalized pustular psoriasis of pregnancy (impetigo herpetiformis) Dermatology 198: 61–64PubMedGoogle Scholar
  2. Hebra F (1872) Über einzelne während der Schwangerschaft, dem Wochenbette, und bei Utermalkrankheiten der Frauen zu beobachtende Hautkrankheiten. Wien Med Wochenschr 48: 1197–1202Google Scholar
  3. Kaposi M (1887) Impetigo herpetiformis. Arch Dermatol Syph 19: 273–296Google Scholar
  4. Moynihan GD, Ruppe JP (1985) Impetigo herpetiformis and hypoparathyroidism. Arch Dermatol 121: 1330–1331PubMedCrossRefGoogle Scholar

Acute Generalized Pustulosis

  1. Beylot C, Doutre MS, Beylot-Barry M (1996) Acute generalized exanthematous pustulosis. Semin Cut Med Surg 15: 244–249CrossRefGoogle Scholar
  2. Braun-Falco O, Luderschmidt C, Maciejewski W et al. (1978) Pustulosis acuta generalisata. Eine ungewöhnliche Erscheinungsform von leukozytoklastischer Vaskulitis. Hautarzt 29: 371–377PubMedGoogle Scholar
  3. MacMillan AL (1973) Generalized pustular drug rash. Dermatologica 146: 285–291PubMedCrossRefGoogle Scholar
  4. Roujeau JC, Bioulac-Sage P, Bourseau C et al. (1991) Acute generalized exanthematous pustulosis. Analysis of 60 cases. Arch Dermatol 127: 1333–1338PubMedCrossRefGoogle Scholar
  5. Tan RSH (1974) Acute generalized pustular bacterid. An unusual manifestation of leukocytoclastic vasculitis. Br J Dermatol 91: 209–215PubMedCrossRefGoogle Scholar
  6. Zelickson BD, Muller SA (1991) Generalized pustular psoriasis. A review of 63 cases. Arch Dermatol 127: 1339–1345PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • Otto Braun-Falco
    • 1
  • Gerd Plewig
    • 1
  • Helmut H. Wolff
    • 2
  • Walter H. C. Burgdorf
    • 1
  1. 1.Department of Dermatology and AllergologyLudwig Maximilians UniversityMunichGermany
  2. 2.Department of Dermatology and VenerologyUniversity of LübeckLübeckGermany

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