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Betamethasone Dipropionate
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A patient with flexural eczema was treated in a dermatological department with 3 (!) topical corticosteroid preparations, which resulted in a maculopapular rash, first in the flexural areas, then with spread to the legs, arms, abdomen and eyelids after 2 days. There were no pustules and the patient had no fever. In a lesional skin biopsy, under the stratum corneum and in the stratum spinosum some pools of neutrophils were found, which formed variable sized pustules. Patch tests were positive to the 3 steroid preparations and their ingredients betamethasone valerate and betamethasone dipropionate. The authors diagnosed ‘generalized exanthematous reaction with pustulosis induced by topical corticosteroids’ (8). That no pustules were seen clinically seems somewhat contradictory to the ‘with pustulosis’ part.
Skin
Published in A. Sahib El-Radhi, Paediatric Symptom and Sign Sorter, 2019
The presence of pustular or vesico-pustular skin lesions on a child's skin is a cause of concern to the family. A pustule is a superficial elevated lesion containing pus. It may primarily result from a bacterial infection, usually staphylococcal, or else when the content of a vesicle or bulla becomes secondarily infected. Pustules are similar to vesicles, but the fluid they contain is purulent exudate. The fluid is the product of accumulation of leukocytes, microorganisms and cellular debris. It may occur either as a primary (e.g. bullous impetigo) or secondary infection of another skin condition (infected AD). When pustules arise at the opening of hair follicles, the condition is termed folliculitis. Not all pustules have infectious contents; for example, the contents of transient neonatal pustulosis are sterile without microorganisms if cultured.
Skin
Published in A Sahib El-Radhi, James Carroll, Paediatric Symptom Sorter, 2017
A Sahib El-Radhi, James Carroll
A pustule is a superficial, elevated lesion containing pus. It may primarily result from a bacterial infection, usually staphylococcal, or when the content of a vesicle or bulla becomes secondarily infected. Pustules are similar to vesicles, but the fluid they contain is a purulent exudate resulting from accumulation of leukocytes, microorganisms and cellular debris. It may occur either as a primary (e.g. bullous impetigo) or secondary infection (e.g. infected atopic dermatitis). When pustules arise at the opening of hair follicles, the condition is termed folliculitis. Not all pustules have infectious contents, e.g. the contents of transient neonatal pustulosis are sterile without microorganisms if cultured.
Improvement of palmoplantar pustulosis after excision of polyacrylamide injected into the nasal region
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Kazuya Kashiyama, Jinyoung Lee, Kazufumi Koga, Yumi Matsuo, Katsumi Tanaka
In the present case, wound culture was performed multiple times before palmoplantar pustulosis was diagnosed at the dermatology department and after initiating steroid treatment, but no bacteria were detected in any of the cultures, which were all aseptic. MRCNS was detected in the culture of a fluid that leaked through the incision during surgery at our department, but no bacteria were detected by the culture of a specimen collected from the back of the lesion. As MRCNS was also detected in nasal culture routinely performed before surgery, we considered that infection of the PAAG-retained region was not established and PAAG was the cause of the palmoplantar pustulosis. However, it is well known that focal infection is a cause of the development and aggravation of palmoplantar pustulosis [15,16]. Regarding the association between PAAG and autoimmune diseases like palmoplantar pustulosis, the immunohistological investigation is necessary in many cases to clarify a causal relationship.
Sterile pustulosis as a rare side effect of fractional bipolar radiofrequency device: a case report
Published in Journal of Cosmetic and Laser Therapy, 2019
Sandhya Deverapalli, Nellie Konnikov
FRF, eTwo technology, is independent of chromophores and can potentially be used on all skin types with minimal pigmentary side effects. Excellent results are noted post treatment for acne scars, skin laxity, rhytides, and dermatoheliosis (3). Some of the expected treatment-related side effects include transient erythema, edema, and superficial crusting lasting between 48 hours and 7 days (4,5). Unusual side effects include inflammatory erythematous papules distributed in the pattern of the radiofrequency electrode applicator. Histopathological examination showed dermal edema with lymphohistiocytic infiltrate (5). Sterile pustulosis post FRF treatment has never been reported to the best of our knowledge. A possible explanation for this phenomenon is an idiosyncratic effect related to the heat generated by the radiofrequency device or a peculiar immune response of the patient’s skin on infliximab therapy.
Acute generalized pustular bacterid concomitant with erythema nodosum, polyarthritis, and Achilles tendinitis
Published in Modern Rheumatology, 2019
Yuki Arita, Hiroaki Taguchi, Ryota Hanada, Toshihiro Tono, Yasuo Ohsone, Utako Okata, Rie Irie, Yutaka Okano
The most probable clinical diagnosis was AGPB and EN. We performed a subsequent skin biopsy in order to confirm the diagnosis and obtained typical histopathological findings of AGPB and EN (Figure 2). Since one of the most prominent features was generalized pustulosis in her clinical manifestations, we focused on the differential diagnosis for other pustule diseases such as palmoplantar pustulosis (PPP), acute generalized exanthematous pustulosis (AGEP), and pustule psoriasis. Patients with PPP typically do not have systemic symptoms, such as high fever, and their lesions do not have the histopathological features of leukocytoclastic vasculitis. Patients with AGEP can have generalized plural pustules and histopathological findings of leukocytoclastic vasculitis, but eruption occurs suddenly within 48 h after the administration of drugs, for example, antibiotics, in many cases [2]. Patients with pustular psoriasis should have plaques of erythema. Since this patient had high fever, histological findings of LV, no prior drug administrations, and no plaques of erythema, we concluded that her skin lesions were AGPB. Bilateral Achilles tendinitis was observed on physical examination, but the enthesitis was not confirmed by imaging techniques. Therefore, she was finally diagnosed as having AGPB concomitant with EN and rheumatic manifestations such as polyarthritis and Achilles tendinitis.