1/20. Generalized pustular psoriasis of pregnancy (impetigo herpetiformis).A 17-year-old woman had a sudden eruption of pustules in her intertriginous areas as well as of erythematosquamous plaques on the scalp, elbows, palms and soles in the third trimester of her first pregnancy. Histopathological evaluation of a biopsy revealed typical changes of pustular psoriasis with parakeratosis and abscesses of neutrophils (Kogoj's spongiform pustules). The diagnosis of pustular psoriasis was established by the typical clinical and histopathological findings. Laboratory parameters showed a highly elevated blood sedimentation rate, hypoferric anemia and decreased albumin levels. serum concentrations of parathormone and its metabolites were normal. After systemic treatment with glucocorticosteroids and antibiotics, the lesions improved but did not clear. After delivery of a healthy boy, therapy was switched to retinoid photochemotherapy with isotretinoin and PUVA that resulted in rapid and complete clearing of the eruption. The coincidence of plaque-type psoriasis and a pustular eruption as described previously in impetigo herpetiformis supports the view that this dermatosis of pregnancy is a variant of generalized pustular psoriasis.- - - - - - - - - - ranking = 1keywords = dermatosis (Clic here for more details about this article) |
2/20. A case of recurrent impetigo herpetiformis with a positive family history.impetigo herpetiformis is a rare non-infectious pustular dermatosis of pregnancy. A few non-gestational cases due to oral contraceptive use have also been reported. Although the disorder is not thought to have a genetic background, there are some familial case reports in the literature. We describe a case of recurrent impetigo herpetiformis in an 18-year-old pregnant woman who had normal serum calcium levels and responded well to prednisolone therapy. Interestingly, the patient's mother had also experienced a generalised pustular dermatosis associated with hypocalcaemia during oral contraceptive use, which was diagnosed clinically and histologically as impetigo herpetiformis.- - - - - - - - - - ranking = 344.02031379661keywords = pustular dermatosis, dermatosis (Clic here for more details about this article) |
3/20. Recurrent impetigo herpetiformis in a pregnant adolescent: case report.impetigo Herpetiformis is a rare pustular dermatosis that typically occurs in pregnant women with unknown etiology. A 17 year old patient who developed impetigo Herpetiformis for the second time in the 27th week of her 2nd pregnancy is presented. The patient improved with corticosteroids treatment but the lesions did not clear completely and had flare ups during stressful periods which brings us to conclusion that impetigo Herpetiformis at least has a common pathway with Generalized Pustular psoriasis in the pathogenesis as stress provoked exacerbations.- - - - - - - - - - ranking = 172.0101568983keywords = pustular dermatosis, dermatosis (Clic here for more details about this article) |
4/20. Differential pathomechanisms of epidermal necrolytic blistering diseases.staphylococcal scalded skin syndrome (SSSS) results from the effect of exfoliative-toxins produced by staphylococcal strains. The disease affects predominantly children, and is rare in adults. We report two cases of the adult type of SSSS. Corticotherapy, chronic alcohol abuse and epilepsy-related immune changes might have been predisposing factors in these patients. The immunopathological characteristics of the inflammatory cell infiltrate in adults SSSS have not been thoroughly explored so far in the literature. Biopsies from 2 patients with bullous SSSS skin were studied by means of immunochemistry using a panel of 10 antibodies directed to FXIIIa, CD15, CD31, CD45R0, CD50, CD54, CD62E, CD95, CD106, and L1-protein, respectively. Cutaneous biopsies from related blistering diseases were compared. They included drug-induced toxic epidermal necrolysis (TEN), bullous impetigo and superficial pemphigus. A dense cell infiltrate composed of granulocytes (CD15 ), macrophages (L1 protein ) and memory T cells (CD45R0 ) and a strong expression of ICAM-3 (CD50) were present in the epidermis. CD95 keratinocytes were lining the intraepidermal blisters. Type I dermal dendrocytes (factor xiiia ) were numerous and plump in the dermis. Bullous impetigo exhibited the same pattern of inflammatory cells, but with a lower density in type I dermal dendrocytes. TEN differed from SSSS by both the absence of CD15 granulocytes and a stronger expression of the pro-apoptotic CD95 antigen in the epidermis. In superficial pemphigus, CD95 antigen was not expressed, and CD15 granulocytes, CD45R0 lymphocytes and L1 protein monocytes were much less numerous. It is concluded that the specific binding of SSSS-induced exotoxins to the desmosomes alters the keratinocyte metabolism leading to an inflammatory reaction followed by focal apoptosis. Our findings are in line with the concept that SSSS exotoxins might be superantigens. A common pathomechanism leading to epidermal destruction is likely operative in SSSS and bullous impetigo. The inflammatory cell composition in TEN and superficial pemphigus markedly differs from that in SSSS.- - - - - - - - - - ranking = 10.445703177625keywords = bullous (Clic here for more details about this article) |
5/20. Neonatal erythema multiforme major.A 25-day-old neonate developed an unusual eruption with bullae and marked systemic symptoms. Investigation for bacterial, viral, autoimmune and immunobullous causes did not reveal any identifiable trigger and histological examination was highly suggestive of bullous erythema multiforme. Pulmonary infiltrates were noted late in the course of the disease. Differential diagnoses included bullous impetigo, primary herpes simplex infection, immunobullous disease, neonatal lupus and erythema multiforme. This case illustrates the difficulties in diagnosing and managing an unwell child with bullae and emphasizes the need to exclude treatable underlying causes.- - - - - - - - - - ranking = 13.927604236834keywords = bullous (Clic here for more details about this article) |
6/20. impetigo neonatorum associated with late onset group B streptococcal meningitis.We present a case of nonbullous impetigo neonatorum associated with late onset group B streptococcal meningitis in a 12-day-old infant. Both skin lesions and meningitis resolved with antibiotic therapy. This is the first reported case of meningitis during the course of this skin disease.- - - - - - - - - - ranking = 8.0332219747603keywords = skin disease, bullous (Clic here for more details about this article) |
7/20. Bullous impetigo caused by group A streptococci. A case report.Bullous impetigo is considered to be a staphylococcal disease. staphylococcus aureus, phage type 71, produces an epidermolytic toxin, assumed to be the cause of bullous formation in the skin. We present a case of bullous impetigo. Microbiological tests suggested beta-hemolytic streptococci, group A, M-type 3, as the etiological agent. Group A streptococci were isolated from the throat of the patient's mother and brother. The strains were shown to be identical, by means of dna-'fingerprinting' and M-typing.- - - - - - - - - - ranking = 6.963802118417keywords = bullous (Clic here for more details about this article) |
8/20. Relapsing bullous staphyloderma.Relapsing eruptions of bullae rapidly turning into pustules were seen in a 69-year-old woman of good general health. At different times during several months of observation, strains of S. aureus were grown from various lesions, including one (phage group III) producing enterotoxin C. Systemic involvement except for high BSR was absent and repeated blood cultures were negative. Histopathological findings resembled impetigo. Antibiotic treatment was effective. As this disease does not fit into any of the well-known pustular infectious dermatoses, we suggest calling it relapsing bullous staphyloderma.- - - - - - - - - - ranking = 17.409505296042keywords = bullous (Clic here for more details about this article) |
9/20. Pustular impetigo with good response to clarithromycin.impetigo is a contagious superficial pyogenic infection of the skin caused by staphylococcus aureus and/or by group A streptococcus. Two main clinical forms are recognized: bullous impetigo and non-bullous impetigo. We present an unusual case of pustular impetigo in a 35-year-old man. The pustules were localized symmetrically in the groin and the patient was successfully treated with clarithromycin. In bullous impetigo, exfoliative toxins produced by staphylococcus aureus are accepted as the basis for the bulla formation just below the stratum granulosum. Although clarithromycin is considered to be a second-choice therapy for bullous impetigo, it was highly effective in our case.- - - - - - - - - - ranking = 13.927604236834keywords = bullous (Clic here for more details about this article) |
10/20. Generalized bullous impetigo in a neonate.Generalized bullous impetigo is uncommon in healthy and term neonates. It must be differentiated from staphylococcal scalded skin syndrome and other commonly encountered vesiculopustular lesions. We report generalized bullous impetigo in an otherwise healthy neonate.- - - - - - - - - - ranking = 20.891406355251keywords = bullous (Clic here for more details about this article) |
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