Generalized Pustular Psoriasis in Childhood: A Rare Case

Vella Asnawi, Mimi Maulida, Nanda Earlia, Arie Hidayati, Fitri Dewi Ismida, M. R. Liana, Karamina Maghfirah, Mikyal Bulqiah
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Abstract

Background: Generalized pustular psoriasis (GPP) rarely occurs under 10 years of age. GPP is typically characterized by an eruption of generalized pustules accompanied by systemic symptoms such as fever for several days, malaise, and anorexia. Pustules are sterile, with a size of 2-3 mm, and spread over the trunk and extremities. This disease can be life-threatening; therefore, optimal therapy is required. Purpose: to report a rare case of GPP in childhood. Case: A 4-year-old girl with complaints of widespread red patches that spread to her neck, back, and hands, with red patches turning into streaks that are partially pus-filled and itchy. In almost all parts of the body, skin abnormalities were seen in the form of generalized erythematous plaques, well-defined borders, multiple pustules on the edges, and some plaques covered by thick scales and crusts. In the calculation of body surface area (BSA), the result is 44%, and in the calculation of generalized pustular psoriasis area and severity index (GPPASI), the result is 21.30. The patient was treated with combination topical therapy of 3% salicylic acid, desoximethasone cream 0.25%, momethasone cream 0.1% vaseline albume as emollients, and coal tar. Significant improvement was seen after 1 month of therapy. Discussion: GPP in children is a rare case. GPP is idiopathic and can be life-threatening. Until now, there has been no standard therapy that is considered the most effective and safe for children. Topical therapy may be an option.
儿童期泛发性脓疱型银屑病:罕见病例
背景:泛发性脓疱型银屑病(GPP)很少发生在 10 岁以下的儿童身上。泛发性脓疱型银屑病的典型特征是全身泛发脓疱,伴有全身症状,如发热数天、精神萎靡和厌食。脓疱无菌,大小为 2-3 毫米,遍布躯干和四肢。这种疾病可能危及生命,因此需要进行最佳治疗。目的:报告一例罕见的儿童 GPP 病例。病例:一名 4 岁女孩,主诉广泛的红色斑块扩散到她的颈部、背部和手部,红色斑块变成条状,部分化脓并发痒。全身几乎所有部位的皮肤都出现异常,表现为全身性红斑,边界清楚,边缘有多个脓疱,有些斑块被厚厚的鳞屑和结痂覆盖。体表面积(BSA)计算结果为 44%,泛发性脓疱型银屑病面积和严重程度指数(GPPASI)计算结果为 21.30。患者接受了 3% 水杨酸、0.25% 地索米松乳膏、0.1% 凡士林润肤霜和煤焦油的联合局部治疗。治疗 1 个月后,症状明显好转。讨论儿童 GPP 病例十分罕见。GPP 是一种特发性疾病,可危及生命。到目前为止,还没有一种被认为对儿童最有效、最安全的标准疗法。局部治疗可能是一种选择。
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