| Impetigo herpetiformis | |
|---|---|
| Other names | Pustular psoriasis of pregnancy |
| Specialty | Dermatology, obstetrics  |
Impetigo herpetiformis is a form of severe pustular psoriasis occurring in pregnancy[1][2] which may occur during any trimester.[3][4]
| Impetigo herpetiformis | |
|---|---|
| Other names | Pustular psoriasis of pregnancy |
| Specialty | Dermatology, obstetrics |
Impetigo herpetiformis is a form of severe pustular psoriasis occurring in pregnancy[1][2] which may occur during any trimester.[3][4]
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]
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]
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]
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]
