Subcorneal Pustular Dermatosis with Temporary Autoimmune Features during COVID-19 Pandemic

Authors

  • Uwe Wollina Department of Dermatology and Allergology, Academic Teaching Hospital, Dresden, Germany
  • André Koch Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany
  • Gesina Hansel Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany
  • Caroline Fürll Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany
  • Jacqueline Schönlebe Institute of Pathology “Georg Schmorl,” Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany

DOI:

https://doi.org/10.3889/oamjms.2020.4870

Keywords:

Neutrophilic dermatoses, Autoantibodies, Subcorneal pustular dermatosis, Coronavirus disease 2019 pandemic

Abstract

Subcorneal pustular dermatosis, Sneddon-Wilkinson, is an uncommon neutrophilic dermatosis of unknown etiology. We report on a 51-year-old woman who presented with multiple superficial erythematous erosions surrounded by annular arranged sterile pustules concentrated on the trunk, the neck, and the proximal extremities during the coronavirus disease-19 pandemic. Larges pustules and flaccid bullae showed a hypopyon. There were no fever and no pruritus, general health was unaffected. Laboratory investigations revealed leukocytosis, neutrophilia, lymphopenia, and increased C-reactive protein. Initially, antinuclear antibodies, pemphigoid antibodies, and antibodies to BP 230 were positive, but negative 5 days later. Nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA tested by real-time reverse-transcriptase-polymerase chain reaction. A diagnostic skin biopsy showed epidermal spongiotic vesiculation and subcorneal pustulation with acantholysis and an inflammatory infiltrate composed of neutrophils and lymphocytes. The confirmed diagnosis was subcorneal pustular dermatosis Sneddon-Wilkinson. She was treated by dapsone and corticosteroids with the latter tempered down. Clinical response was rapid. We suggest that the autoimmune features seen on admission may be due to an undefined viral infection, but not SARS-CoV-2.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Filosa A, Filosa G. Neutrophilic dermatoses: a broad spectrum of disease. G Ital Dermatol Venereol. 2018;153(2):265-272.

Sneddon IB, Wilkinson DS. Subcorneal pustular dermatosis. Br J Dermatol. 1956;68(12):385-394.

Watts PJ, Khachemoune A. Subcorneal Pustular Dermatosis: A Review of 30 Years of Progress. Am J Clin Dermatol. 2016;17(6):653-671.

Scalvenzi M, Palmisano F, Annunziata MC, Mezza E, Cozzolino I, Costa C. Subcorneal pustular dermatosis in childhood: a case report and review of the literature. Case Rep Dermatol Med. 2013;2013:424797.

Gillihan R, Merritt J, Beers P, Longo MI. Hypopyon pustules of Sneddon-Wilkinson disease. Int J Dermatol. 2019;58(5):605-606.

Salmi TT. Dermatitis herpetiformis. Clin Exp Dermatol. 2019;44(7):728-731.

Düker I, Schaller J, Rose C, Zillikens D, Hashimoto T, Kunze J. Subcorneal pustular dermatosis-type IgA pemphigus with autoantibodies to desmocollins 1, 2, and 3. Arch Dermatol. 2009;145(10):1159-1162.

Hashimoto T, Teye K, Ishii N. Clinical and immunological studies of 49 cases of various types of intercellular IgA dermatosis and 13 cases of classical subcorneal pustular dermatosis examined at Kurume University. Br J Dermatol. 2017;176(1):168-175.

Bordignon M, Zattra E, Montesco MC, Alaibac M. Subcorneal pustular dermatosis (Sneddon-Wilkinson disease) with absence of desmoglein 1 and 3 antibodies: case report and literature review. Am J Clin Dermatol. 2008;9(1):51-55.

Touzeau-Roemer V, Skoll M, Tajpara P, Kienzl P, Wesinger A, Saluzzo S, Bauer M, Aichelburg MC, Bangert C, Bauer W, Stingl G, Rieger A, Grabmeier-Pfistershammer K, Schuster C. Prevalence of Skin-specific Autoantibodies in HIV-infected Patients and Uninfected Controls. Acta Derm Venereol. 2019;99(11):978-983.

Bundell C, Brunt SJ, Cysique LA, Brusch A, Brew BJ, Price P. The high frequency of autoantibodies in HIV patients declines on antiretroviral therapy. Pathology. 2018;50(3):313-316.

Kurien G, Jamil RT, Preuss CV. Dapsone. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020.

Downloads

Published

2020-06-05

How to Cite

1.
Wollina U, Koch A, Hansel G, Fürll C, Schönlebe J. Subcorneal Pustular Dermatosis with Temporary Autoimmune Features during COVID-19 Pandemic. Open Access Maced J Med Sci [Internet]. 2020 Jun. 5 [cited 2024 Nov. 4];8(T1):12-5. Available from: https://oamjms.eu/index.php/mjms/article/view/4870