ACUTE GENERALIZED EXANTHEMATIC PUSTULOSES (4 CASES)

  • 1 January 1980
    • journal article
    • research article
    • Vol. 107  (1-2) , 37-48
Abstract
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 there exists 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. Pustuloses exist in many forms although they have certain common points: 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 which sometimes this takes the form of a leucocytoclastic vasculitis or a polymorphic infiltrate which is rich in intact eosinophils. Direct immunofluorescence shows deposits of complement component 3 and occasionally immunoglobulin M 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 hypersensitity mechanism. Pustulosis should not be considered as psoriatic. A pustulosis in patients with a genetic psoriatic predisposition is rare yet possible. The common heading of acute generalized exanthematic pustulosis is proposed.

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