[Acute generalized exanthematic pustuloses (four cases) (author's transl)]. 1980

C Beylot, and P Bioulac, and M S Doutre

Acute generalized exanthematic pustuloses supervening without a genetic psoriatic predisposition are not exceptional if the literature over the last few years is taken into account. Such observations are published under a wide range of names. Beside exanthematic pustular psoriasis as defined by Baker and Ryan, there exists in fact a whole scale of amicrobial pustulosis: acute generalized pustular bacterid; acute generalized pustulosis manifestation of leukocytoclastic vasculitis; pustular necroziting angeitis; pustular eruption with eosinophilic abscesses; generalized pustular drug rash; subcorneal pustules in erythema multiforme and in Sweet's syndrome. Thus, it appears that pustuloses exist in many forms, although they have certain common points that justify a synthetic perspective:--their occurrence, after a bout of infection and/or after taking drugs in subjects with no previous known psoriasis;--a single outbreak occurring spontaneously or with corticoid therapy and which heals by itself;--the existence of a marked vasculitis which occurs before the epidermal pustules. Sometimes this takes the form of a leucocytoclastic vasculitis or a polymorphic infiltrate which is rich in intact eosinophils. Direct immunofluorescence shows deposits of C3 and occasionally IgM at the vascular wall. The circulating antibody-antigen complex produced by an infection and/or by a drug may be responsible of the pustulosis by a hypersensibility mechanism (type Arthus phenomen). From the existing literature and the personal observations of four cases, the authors have made a general review of these pustuloses. They believe that in the majority of cases, pustulosis should not be considered as being psoriatic. However, the authors discuss the rare but possible occurrence of such a pustulosis in patients with a genetic psoriatic predisposition. They feel it would be preferable to avoid the publication of observations under a too wide a range of names, and propose the common heading of "acute generalized exanthematic pustulosis".

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011565 Psoriasis A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. Palmoplantaris Pustulosis,Pustular Psoriasis of Palms and Soles,Pustulosis Palmaris et Plantaris,Pustulosis of Palms and Soles,Psoriases
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004804 Eosinophils Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. Eosinophil
D005076 Exanthema Diseases in which skin eruptions or rashes are a prominent manifestation. Classically, six such diseases were described with similar rashes; they were numbered in the order in which they were reported. Only the fourth (Duke's disease), fifth (ERYTHEMA INFECTIOSUM), and sixth (EXANTHEMA SUBITUM) numeric designations survive as occasional synonyms in current terminology. Rash,Skin Rash,Exanthem,Rash, Skin
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute

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