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Impetigo herpetiformis

Medical condition From Wikipedia, the free encyclopedia

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

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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]

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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

Further reading

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