Subcorneal Pustular Dermatosis with Temporary Autoimmune Features during COVID-19 Pandemic

  • Uwe Wollina Department of Dermatology and Allergology, Academic Teaching Hospital, Dresden, Germany
  • André Koch Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany
  • Gesina Hansel Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany
  • Caroline Fürll Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany
  • Jacqueline Schönlebe Institute of Pathology “Georg Schmorl,” Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany
Keywords: Neutrophilic dermatoses, Autoantibodies, Subcorneal pustular dermatosis, Coronavirus disease 2019 pandemic

Abstract

Subcorneal pustular dermatosis, Sneddon-Wilkinson, is an uncommon neutrophilic dermatosis of unknown etiology. We report on a 51-year-old woman who presented with multiple superficial erythematous erosions surrounded by annular arranged sterile pustules concentrated on the trunk, the neck, and the proximal extremities during the coronavirus disease-19 pandemic. Larges pustules and flaccid bullae showed a hypopyon. There were no fever and no pruritus, general health was unaffected. Laboratory investigations revealed leukocytosis, neutrophilia, lymphopenia, and increased C-reactive protein. Initially, antinuclear antibodies, pemphigoid antibodies, and antibodies to BP 230 were positive, but negative 5 days later. Nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA tested by real-time reverse-transcriptase-polymerase chain reaction. A diagnostic skin biopsy showed epidermal spongiotic vesiculation and subcorneal pustulation with acantholysis and an inflammatory infiltrate composed of neutrophils and lymphocytes. The confirmed diagnosis was subcorneal pustular dermatosis Sneddon-Wilkinson. She was treated by dapsone and corticosteroids with the latter tempered down. Clinical response was rapid. We suggest that the autoimmune features seen on admission may be due to an undefined viral infection, but not SARS-CoV-2.

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Published
2020-06-05
How to Cite
1.
Wollina U, Koch A, Hansel G, Fürll C, Schönlebe J. Subcorneal Pustular Dermatosis with Temporary Autoimmune Features during COVID-19 Pandemic. Open Access Maced J Med Sci [Internet]. 2020Jun.5 [cited 2020Sep.20];8(T1):12-5. Available from: https://www.id-press.eu/mjms/article/view/4870