Image in medicine
Annular pustular psoriasis
Psoriasis pustulosa anular
María Rogel-Vence
, Lucía González-Ruiz, Juan Luis Santiago Sánchez-Mateos
Corresponding author
Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
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Several erythematous scaling annular lesions with raised edges (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) were observed on examination, with pustules (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Culture was negative for microorganisms and a skin biopsy was performed. Topical treatment with clobetasol propionate 0.5<span class="elsevierStyleHsp" style=""></span>mg/g was prescribed on suspicion. The biopsy showed psoriasiform dermatitis with pustule formation. PAS staining was negative for dermatophytes. With these data, the diagnosis of annular pustular psoriasis (APP) was established.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">APP is a subtype of psoriasis characterized by the presence of annular inflammatory plaques, with margins in which sterile pustules form secondary to the accumulation of neutrophils in the epidermis. Differential diagnosis with tinea corporis, bacterial folliculitis or toxic steroids should be performed. When in doubt, it is recommended to take a sample for direct visualization, culture and/or biopsy before starting treatment, avoiding masking (tinea incognita) and the occurrence of complications. Topical treatment of APP consists of the combination of corticosteroids and vitamin D derivatives. In refractory cases, options such as phototherapy, immunomodulators or biological drugs can be considered.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that they have not received funding to carry out this study.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rogel-Vence M, González-Ruiz L, Santiago Sánchez-Mateos JL. Psoriasis pustulosa anular. 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