Subcorneal Pustular Dermatosis (Sneddon-Wilkinson Disease): A Rare Case

Abstract

Subcorneal pustular dermatosis (SPD) is a rare, chronic, recurrent, pustular eruption. It may be difficult to differentiate SPD from Acute Generalized Exanthematous Pustulosis (AGEP) and Generalized Pustular Psoriasis (GPP)just from clinical appeareance. A 48 years old woman with subcorneal pustular dermatosis was reported. She was complained there were tiny blisters containing pus on the reddish patches that felt burning and became widespread to neck, chest, abdomen, arms, groin and legs since 4 days ago. Patient had no history of skin lesion before. From physical examination revealed no other pathologies and on the skin showed erythematous patches with annular lesion, pustules formation that tended to coalesce to form desquamative plaques, erosions, on chest, abdomen, back, arm, buttock and leg. Based on histopathology showed there are subcorneal pustules. The subcorneal pustule is filled with neutrophils and on the dermis, there are mild infiltration of neutrophil cells. This feature revealed to SPD.Clinically it may be difficult to differentiate SPD from AGEP and GPP. Histopathology examination can distinguished these disease,patient was treated with prednisone 40 mg and dapson 100 mg and had improvement after 4 weeks.