Presentation
I present a case of 23 year old female gravida 4 para 3 with recurrent impetigo herpetiformis at 26 weeks gestation. She presented with a one month history of pustular lesions which responded to treatment with prednisone. [ncbi.nlm.nih.gov]
”, PPP can often present or flare even during the postpartum period. [dovepress.com]
The relative infrequency of PPP presents both clinical and pathologic challenges in the diagnosis and management of this condition. [mdedge.com]
Entire Body System
- Fever
Unlike other pregnancy dermatoses, it can be associated with constitutional symptoms including fever, rigors, arthralgia and complications of secondary infection and sepsis. There is an increased risk of fetal anomalies and stillbirths. [casereports.bmj.com]
- Goiter
Full size image Thyroidectomy was performed for toxic nodular goiter during the second trimester. She developed secondary hypoparathyroidism after surgery. She was not compliant with her medications which included calcium, L-thyroxine and vitamin D. [casesjournal.biomedcentral.com]
- HELLP Syndrome
[…] abortive outcome Abortion Ectopic pregnancy Abdominal Cervical Interstitial Ovarian Heterotopic Embryo loss Fetal resorption Molar pregnancy Miscarriage Stillbirth Edema, proteinuria, and hypertensive disorders Gestational hypertension Pre-eclampsia HELLP [en.wikipedia.org]
Jaw & Teeth
- Lesion of the Tongue
The oral mucosa is sometimes involved with pustules that leave circinate or erosive lesions on the tongue or buccal mucosa. [dermnetnz.org]
Skin
- Pustular Rash
At 35 weeks' gestation, the patient developed a severely pruritic pustular rash with fever and leukocytosis. The skin of the affected areas was biopsied and showed intraepidermal pustules with a neutrophilic infiltrate. [ncbi.nlm.nih.gov]
Henson TH, Tuli M, Bushore D, Talanin NY: Recurrent pustular rash in a pregnant woman. Arch Dermatol 2000;136:1055-1060. Baker H, Ryan TJ: Generalized pustular psoriasis. A clinical and epidemiological study of 104 cases. [karger.com]
- Skin Rash
Pustular psoriasis of pregnancy should be considered in a pregnant woman with a spreading pustular skin rash and constitutional symptoms. [dermnetnz.org]
Several skin rashes that occur during pregnancy are abnormal and potentially harmful to the fetus. Whenever an unusual rash occurs in pregnancy, medical attention should be sought as soon as possible. [livestrong.com]
Contact dermatitis is an allergic skin reaction that produces an itchy, red skin rash. The rash may consist of raised, red bumps that ooze, drain, or crust. Corns or calluses are rough, thickened areas of skin. [healthline.com]
Breast
- Breast Engorgement
engorgement Childbirth-related post-traumatic stress disorder Diastasis symphysis pubis Postpartum bleeding Peripartum cardiomyopathy Postpartum depression Postpartum infections Postpartum psychosis Postpartum thyroiditis Puerperal mastitis Other Concomitant [en.wikipedia.org]
Workup
Laboratory workup revealed leukocytosis of 21.5×109/L (reference range, 4.5–11.0×109/L) with neutrophilic predominance of 73.6% (reference range, 56%), an elevated erythrocyte sedimentation rate (ESR) of 40 mm/h (reference range, 0–20 mm/h), and a mild [mdedge.com]
[…] materials: o Classification, o Suture size, o Type and size of needle ♦ Types of suturing: o simple interrupted, o mattress, vertical & horizontal o Intradermal buried, o S.C. buried, o Running subcuticular, o Figure of 8 ♦ Suture removal ♦ Preoperative workup [medicaldialogues.in]
Treatment
Although many treatment options have been proposed for IH, there is no specific guideline and the evidence for efficacy of treatments is poor. [ncbi.nlm.nih.gov]
Prognosis
It was previously associated with high maternal and fetal mortality and morbidity, but now has a better prognosis. [ncbi.nlm.nih.gov]
Pustular psoriasis of pregnancy carries a poor prognosis for mother and/or fetus if untreated. [dermnetnz.org]
Early diagnosis and proper treatment is important in order to get a better prognosis for both the mother and baby. [e-sciencecentral.org]
Etiology
The etiology of the disease is unclear and it is not known if genetic factors play a role. We present two sisters (twins) with impetigo herpetiformis supporting an inheritance pattern. [ncbi.nlm.nih.gov]
Abstract Impetigo Herpetiformis is a rare pustular dermatosis that typically occurs in pregnant women with unknown etiology. [unboundmedicine.com]
Epidemiology
♦ Skin testing ♦ Radiological and imaging ♦ Commonly used laboratory tests examination ♦ Oral provocation test EPIDEMIOLOGY OF SKIN DISEASE Must know Should know Good to know ♦ What is epidemiology and why is it relevant to dermatology ♦ Describing [medicaldialogues.in]
Baker H, Ryan TJ: Generalized pustular psoriasis: a clinical and epidemiological study of 104 cases. Brit J Dermatol 1968;80:77. [karger.com]
A clinical and epidemiological study of 104 cases. Br J Dermatol 80:771–793 PubMed CrossRef Google Scholar 4. Beveridge G W, Harkness RA, Livingstone JR (1966) Impetigo herpetiformis in two successive pregnancies. [link.springer.com]
Pathophysiology
A better understanding of the pathophysiology of AIKD is likely to lead to innovative, targeted therapies that benefit patients. [kclpure.kcl.ac.uk]
On the other hand, the contribution of innate immunity in the disease pathophysiology of SJS/TEN has been largely unexplored. [mdpi.com]
Ischaemic ulcer DISORDER OF LYMPHATIC VESSELS Must know Should know Good to know ♦ Lymphangiogenesis ♦ Functional Anatomy of skin lymphatics ♦ Identification of skin lymphatics ♦ Lymph transport ♦ Immune function ♦ Oedema/Lymphoedema o Epidemiology o Pathophysiology [medicaldialogues.in]
Pathophysiology and treatment of psoriasis.Am. J. Health Syst. [ejog.org]
Prevention
Efforts should be directed toward maintaining the general condition of the patient and toward the prevention and control of secondary infection. In pregnancy the disease is an indication for termination and the prevention of future pregnancies. [ajog.org]
Impetigo herpetiformis is a rare dermatosis of pregnancy that requires early recognition and treatment to prevent maternal and fetal morbidity. Combination therapy using oral corticosteroids and short-term methotrexate is effective. [ncbi.nlm.nih.gov]
Your skin Holds body fluids in, preventing dehydration Keeps harmful microbes out, preventing infections Helps you feel things like heat, cold, and pain Keeps your body temperature even Makes vitamin D when the sun shines on it Anything that irritates [icdlist.com]