Acute respiratory distress syndrome complicating generalized pustular psoriasis (psoriasis-associated aseptic pneumonitis)

Journal of the American Academy of Dermatology
Nicolas KlugerCéline Girard

Abstract

Generalized pustular and/or erythrodermic psoriasis may have severe or even lethal complications. A peculiar noninfectious acute respiratory distress syndrome (so-called "sterile pneumonitis") has been described in generalized pustular psoriasis and/or erythrodermic psoriasis. We report a new case in a 14-year-old girl with a long history of pustular psoriasis and review the published work on this complication. The girl developed sterile pneumonitis during a disease flare-up, and high-dose corticosteroid therapy was quickly initiated. Within a few days, her clinical and radiological status was dramatically improved. The pathogenesis of aseptic pneumonitis is unknown, but various proinflammatory cytokines have been implicated, especially tumor necrosis factor-alpha, which could play a role in the recruitment of leukocytes to the lung. This complication has rarely been reported but should be more widely known as the differential diagnoses include congestive heart failure, acute lung infection related or unrelated to immunosuppressive therapy, and drug hypersensitivity reaction. Early recognition would avoid delays in the correct management of this potentially lethal complication, which requires high-dose systemic corticosteroid t...Continue Reading

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Citations

Feb 5, 2014·Burns : Journal of the International Society for Burn Injuries·Katherine M VarmanLouis R Pizano
Jan 7, 2014·Journal of the American Academy of Dermatology·Claudia J Posso-De Los Rios, Elena Pope
Nov 18, 2014·The Australasian Journal of Dermatology·Oscar Suárez-AmorAquilina Ramírez-Santos
Jun 4, 2014·Pediatric Dermatology·Claudia J Posso-De Los RiosIrene Lara-Corrales
Jun 1, 2018·Experimental Dermatology·Alexander BoehnerKilian Eyerich
Jul 4, 2020·Expert Opinion on Drug Safety·Wen-Ming Wang, Hong-Zhong Jin
Feb 6, 2020·Paediatric Drugs·Yi-Wei Huang, Tsen-Fang Tsai
Jul 17, 2020·Respiratory Medicine Case Reports·Sarah KhanCreticus Marak
Mar 13, 2021·Case Reports in Dermatology·Lamya NoureBenjamin Bondue

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