Subcorneal pustular dermatosis is a rare, chronic neutrophilic dermatoses characterized by recurrent, sterile pustules localized to the trunk, intertriginous regions and flexural surfaces of extremities. The diagnosis of disease is made by demonstration of subcorneal pustules containing neutrophils histopathologically and negative immunofluorescence staining. We reported a 68-year-old male patient with subcorneal pustular dermatosis, who was misdiagnosed as dermatitis herpetiformis without performing direct immunofluorescence examination and had been treated with dapsone with partial benefit for 20 years. He was admitted to our clinic because of the increasing complaints after the cessation of dapsone treatment 2 months before due to development of anemia. The diagnosis of subcorneal pustular dermatosis was made clinically and histopathologically. Complete remission was achieved with systemic acitretin treatment. With this case, we want to emphasize that direct immunofluorescence examination is necessary in order to distinguish subcorneal pustular dermatosis from dermatitis herpetiformis and IgA pemphigus. Acitretin can be a safe and effective treatment option for these patients.
Havva Ozge Keseroglu, Necip Enis Kaya, Aysun Gokce, Muzeyyen Gonul
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