Subcorneal Pustular Dermatosis

Subcorneal Pustular Dermatosis General Information

Skin disorders are delicate health problems because they are very hard to treat and can easily affect the patient’s quality of life. Most people are very careful with their appearance and if they get a skin disease, they usually suffer psychological damage, especially if their medical condition is obvious (affecting large areas of skin). Most patients are not very well informed in what concerns their medical disorder or just ignore it. We will present you some of the most important pieces of information about Subcorneal Pustular Dermatosis, a very rare condition, also known as Sneddon-Wilkinson disease.

This chronic medical condition involves the appearance of pustules and blisters on the flexural areas, armpits and trunks. These usually develop in cops over months and/or even years. Specialists associate Subcorneal Pustular Dermatosis with various different conditions, for example thyroid dysfunctions (hypo- and hyperthyroidism), lupus, multiple myeloma, accumulation of abnormal proteins in the blood stream (IgA monoclonal gammopathy), rheumatoid arthritis and pyoderma gangrenosum. No particular geographic predominance is known, but worldwide cases were reported. Subcorneal Pustular Dermatosis has no race or ethnic predilection and affects more women than men and is more common among patients who are over 45 years old. This type of skin disorder is not fatal for the patient, being benign. Although, if it is associated with other disorders, as the ones mentioned above, the prognosis is altered and the chances for a full recovery are significantly increased. For further information we advise you to call you health care provider.

Subcorneal Pustular Dermatosis Symptoms

As any other skin condition, Subcorneal Pustular Dermatosis presents some specific signs and symptoms that are usually experienced by the majority of patients. Some of them may accuse some particular and unique signs but this is mainly because our immune system reacts differently when it is attacked by harmful agents. In this second chapter of our presentation we will enumerate some of the most encountered signs and symptoms. But if you still have questions, you can contact your health care provider or a trained specialist in the domain, called a dermatologist.

Subcorneal Pustular Dermatosis appears as flaccid pustules (small primary lesions) that are only 2 to 5 mm (millimeters) in diameter and develop on mildly erythematous or healthy skin. These lesions can be grouped or isolated and because they are superficial, they can result in a superficial crust.  Also, they tend to coalesce and form various patterns: annular, serpiginous or circinate. The classis pustules are described as blisters divided in two that contain a purulent liquid in the lower half. The most sensitive areas that are usually affected by Subcorneal Pustular Dermatosis include the neck, axillae, groin, submammary regions or proximal flexural aspects of the extremities. After the lesions have resolved, mild hyperpigmentation may remain on the skin. The lesions may become itchy with time. Except these signs, the general health status of the patients is good, and a mild tenderness at the surface of the affected skin region may be felt. Sometimes, this skin disorder may be later diagnosed as general pustular psoriasis.

Subcorneal Pustular Dermatosis Treatment

An immediate diagnosis followed by a proper treatment may assure the patient’s full recovery. Subcorneal Pustular Dermatosis, as any other skin disorders demands months of careful and close therapy in order to avoid permanent marks after the disease is resolved, such as hyperpigmentation, increased sensitivity and red skin. We strongly advise you to contact your health care provider as soon as you start experiencing any of the signs and symptoms that we have listed in the anterior chapter. Skin problems need intense medical care so that they do not recur later in the patient’s life. Seeking medical guidance as soon as possible may help you avoid the appearance of further complications that interfere in the process of healing.

The health care provider will perform a physical exam and in order to confirm the diagnosis, a skin biopsy is always needed. To rule out other possible medical conditions or to discover the underlying causes of Subcorneal Pustular Dermatosis, your personal doctor may ask you to do some blood tests to check your calcium levels or CBC (complete blood count) and protein electrophoresis and liver functioning test. As soon as the diagnosis is set, the health care provider must apply immediately the adequate treatment option. The main aim of any form of therapy is to prevent the occurrence of more complications. The main choice is represented by antibiotics and the most commonly used drug is Avlosulfon, prescribed as. Dapsone. The empiric antimicrobial therapy should cover all the pathogens in the context of a clinical setting and must also be comprehensive. Dapsone is preferred because is often successful, resolving the lesions over a month.

Sometimes, once the control of Subcorneal Pustular Dermatosis is established, the treatment must be continued with lower doses to prevent Subcorneal Pustular Dermatosis to recur. Another category of drugs that is very used is represented by retinoids. The most efficient drug from this category is Acitretin, prescribed as Soriatane. Retinoids modulate the differentiation of keratinocytes and reduces the potential of malignant degeneration by decreasing the cohesiveness of the unusual hyperproliferative keratinocytes. This type of medication can also reduce the risk of developing skin cancer in patients with renal transplant. Acitretin (or formally known as Eretinate) is considered a solid alternative medicine for people who are allergic or do not respond to treatment with Dapsone. The prescription must be followed strictly and try to avoid overdosing and losing a dose. Otherwise, severe complications could appear and interfere in the process of healing.

Except these drugs, health care providers can also choose to apply one or more of the following treatment options: Sulfamethoxypyridazine, Colchixine, phototherapy (using Psoralen with PUVA or narrowband and broadband UVB) alone or in combination with antibiotics or retinoids, Sulfapyridine, immune suppressants (for example Mycophenolate Mofetil and Cyclosporine) and Adalimumab, Infliximab or other biological response mediators. Patients who deal with Subcorneal Pustular Dermatosis usually need long-term medication followed by consistent examination of the immunophoresis and serum protein electrophoresis in order to avoid developing complications after several years, such as myeloma or paraproteinemia.