Treatment of generalized pustular psoriasis in pregnancy with systemic corticosteroid: A rare case report

Ann Med Surg (Lond). 2022 Sep 10:82:104568. doi: 10.1016/j.amsu.2022.104568. eCollection 2022 Oct.

Abstract

Introduction: and importance: Generalized pustular psoriasis of pregnancy (GPPP) is a rare dermatosis that causes maternal and fetal morbidity and mortality. Pustular psoriasis of pregnancy (PPP) is a challenging dermatological Condition, which can have impact on the life pregnant woman's and her unborn child's life.

Case presentation: Here we report a 26-year-old woman with a history of persistent plaque psoriasis presented with generalized pustular lesions. Ultrasonography revealed normal fetal development despite high serum ESR and CRP levels. Pustular psoriasis was confirmed by histopathology. The patients were given systemic prednisolone 32 mg once daily, which was raised to 60 mg once daily on the tenth day of treatment to manage fresh outbreaks, and the patient's rash continued to gradually improve. When the lesions faded after 4 weeks of treatment, the dose was reduced to 16 mg/day. At 31 weeks' gestation, the patient was discharged and she was kept on prednisolone at a low dose of 4 mg once daily for the duration of the pregnancy.

Clinical discussion: Generalized pustular psoriasis of pregnancy (GPPP), herpetiformis, is a less common form dermatosis that can be fatal for both mother and the fetus. Response to treatment is good when initiated early in the course of the disease. This present case shows young pregnant mother with GPPP successfully treated with systemic corticosteroid.

Conclusion: Contrary to the majority of other common pregnant dermatosis, pustular psoriasis is an uncommon condition that can have harmful effects on the fetus. Our patient's PPP symptoms included systemic ones as well as body and palm involvement. Close monitoring and administration of systemic corticosteroids ensured secure outcomes.

Keywords: Impetigo herpetiformis; Pustular psoriasis of pregnancy; Systemic prednisolone.

Publication types

  • Case Reports