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Impetigo herpetiformis

Impetigo herpetiformis
Other namesPustular psoriasis of pregnancy
SpecialtyDermatology, obstetrics Edit this on Wikidata

Impetigo herpetiformis is a form of severe pustular psoriasis occurring in pregnancy[1][2] which may occur during any trimester.[3][4]

Signs and symptoms

The typical lesions are centrifugally extending erythematous patches with marginally grouped sterile pustules; they can also develop erosion, crust, and impetiginization. These lesions are mainly seen in flexural regions. Patients may experience vegetative lesions resembling Pemphigus vegetans, though they are uncommon.[5] It is possible to see mucosal lesions in the tongue, mouth, and even esophagus in addition to nail involvement.[6]

In impetigo herpetiformis, hypoparathyroidism and hypocalcemia may be encountered.[7] Systematic symptoms such as malaise, hypovolemic shock, vomiting, chills, fever, diarrhea, and seizures may also be seen.[8]

Causes

The cause of impetigo herpetiformis is not yet clear.[8] Some evidence suggests that genetic factors may play a role in the development of impetigo herpetiformis, such as the number of familial cases.[9]

Diagnosis

The diagnosis of impetigo herpetiformis is supported by clinical and laboratory findings, and histological examination primarily reveals neutrophilc inflammatory infiltrate, epidermal acanthosis, and papillomatosis with focal parakeratosis.[10] Spongiform pustules of Kogoj are intraepidermal multilocular microabscesses that are formed by neutrophil collections.[11]

Laboratory findings include iron deficiency anemia, hypoalbuminemia, hypocalcemia, elevated erythrocyte sedimentation rate, and leukocytosis.[12]

Treatment

Pustular psoriasis is still primarily treated with systemic corticosteroids, which have been used for many years.[13] If a patient is not responding to corticosteroids, cyclosporine may be a useful medication.[14] In impetigo herpetiformis, the use of antibiotics appears to be beneficial, despite the fact that they cannot completely eradicate the illness.[15][16]

See also

References

  1. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 471. ISBN 0-7216-2921-0.
  2. ^ Tunzi M, Gray GR (January 2007). "Common skin conditions during pregnancy". Am Fam Physician. 75 (2): 211–8. PMID 17263216.
  3. ^ "DermIS — Impetigo Herpetiformis (Information on the diagnosis)". Archived from the original on 2018-08-08. Retrieved 2009-11-29.
  4. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  5. ^ Namazi, Nastaran; Dadkhahfar, Sahar (2018). "Impetigo Herpetiformis: Review of Pathogenesis, Complication, and Treatment". Dermatology Research and Practice. 2018. Hindawi Limited: 1–4. doi:10.1155/2018/5801280. ISSN 1687-6105. PMC 5904797. PMID 29849579.
  6. ^ Fouda, Usama M; Fouda, Ragai M; Ammar, Hussam M; Salem, Mohamed; Darouti, Mohamed EL (2009). "Impetigo herpetiformis during the puerperium triggered by secondary hypoparathyroidism: a case report". Cases Journal. 2 (1). Springer Science and Business Media LLC: 9338. doi:10.1186/1757-1626-2-9338. ISSN 1757-1626. PMC 2806392. PMID 20072676.
  7. ^ Sárdy, M; Preisz, K; Berecz, M; Horváth, C; Kárpáti, S; Horváth, A (May 5, 2006). "Methotrexate treatment of recurrent impetigo herpetiformis with hypoparathyroidism". Journal of the European Academy of Dermatology and Venereology. 20 (6). Wiley: 742–743. doi:10.1111/j.1468-3083.2006.01473.x. ISSN 0926-9959. PMID 16836512. S2CID 46004532.
  8. ^ a b Henson, T. H. (August 1, 2000). "Recurrent Pustular Rash in a Pregnant Woman". Archives of Dermatology. 136 (8). American Medical Association (AMA): 1055–a–1060. doi:10.1001/archderm.136.8.1055-a. ISSN 0003-987X. PMID 10926744.
  9. ^ Erbagci, Z; Erkiliç, S (2000). "A Case of Recurrent Impetigo Herpetiformis with a Positive Family History". International Journal of Clinical Practice. 54 (9): 619–620. doi:10.1111/j.1742-1241.2000.tb10938.x. ISSN 1368-5031. PMID 11220992. S2CID 42807497.
  10. ^ Kondo, Rogerio Nabor; Araújo, Fernanda Mendes; Pereira, Allamanda Moura; Lopes, Vivian Cristina Holanda; Martins, Ligia Márcia Mario (2013). "Pustular psoriasis of pregnancy (Impetigo herpetiformis) - case report". Anais Brasileiros de Dermatologia. 88 (6 suppl 1). FapUNIFESP (SciELO): 186–189. doi:10.1590/abd1806-4841.20132134. ISSN 0365-0596. PMC 3875976. PMID 24346915.
  11. ^ Azulay-Abulafia, Luna; Brotas, Arles; Braga, Antônio; Volta, Andréia Cunha; Gripp, Alexandre Carlos (2004). "Psoríase pustulosa da gestação (impetigo herpetiforme): relato de dois casos e revisão da literatura". Revista Brasileira de Ginecologia e Obstetrícia. 26 (2). FapUNIFESP (SciELO): 153–159. doi:10.1590/s0100-72032004000200011. ISSN 0100-7203.
  12. ^ Breier-Maly, J.; Ortel, B.; Breier, F.; Schmidt, J.B.; Hönigsmann, H. (1999). "Generalized Pustular Psoriasis of Pregnancy (Impetigo herpetiformis)". Dermatology. 198 (1). S. Karger AG: 61–64. doi:10.1159/000018066. ISSN 1018-8665. PMID 10026404. S2CID 21334983.
  13. ^ Gao, Qian-Qian; Xi, Ming-Rong; Yao, Qiang (2013). "Impetigo Herpetiformis during Pregnancy: A Case Report and Literature Review". Dermatology. 226 (1). S. Karger AG: 35–40. doi:10.1159/000346578. ISSN 1018-8665. PMID 23446290. S2CID 42999570.
  14. ^ Patsatsi, Aikaterini; Theodoridis, Theodoros D.; Vavilis, Dimitrios; Tzevelekis, Vasilios; Kyriakou, Aikaterini; Kalabalikis, Dimitrios; Sotiriadis, Dimitrios (March 23, 2013). "Cyclosporine in the Management of Impetigo Herpetiformis: A Case Report and Review of the Literature". Case Reports in Dermatology. 5 (1). S. Karger AG: 99–104. doi:10.1159/000350564. ISSN 1662-6567. PMC 3635965. PMID 23626548.
  15. ^ Luan, Li; Han, Shixin; Zhang, Zhenying; Liu, Xiaoming (December 10, 2013). "Personal treatment experience for severe generalized pustular psoriasis of pregnancy: two case reports". Dermatologic Therapy. 27 (3). Hindawi Limited: 174–177. doi:10.1111/dth.12112. ISSN 1396-0296. PMID 24517287. S2CID 37248288.
  16. ^ Tintinger, G. R.; Anderson, R.; Feldman, C. (March 15, 2013). "Pharmacological approaches to regulate neutrophil activity". Seminars in Immunopathology. 35 (4). Springer Science and Business Media LLC: 395–409. doi:10.1007/s00281-013-0366-8. ISSN 1863-2297. PMID 23494251. S2CID 253808218.

Further reading
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