Clinical cases

Subcorneal pustular dermatosis (SPD) is an
uncommon condition of unknown etiology that usually
develops after the age of 40 and has a predilection for the
female gender. It is characterized clinically by a chronic,
relapsing symmetric sterile pustular rash that
predominantly involves the flexure surfaces of the trunk
and limbs and histologically by the presence of subcorneal
pustules abundant in neutrophils. SPD can be associated
with systemic diseases, especially lymphoproliferative
diseases, inflammatory bowel disease and rheumatoid
arthritis. Dapsone is the mainstay of treatment, leading to
complete clinical remission in the majority of cases. Cases
refractory to sulphones may respond to oral retinoids,
phototherapy, colchicine, cyclosporine or anti-tumor
necrosis factor α biologic agents.
We report and discuss the case of a 21-year-old female
patient diagnosed with SPD with skin lesions limited to the
lower limbs unresponsive to dapsone and colchicine
treatment and review the literature