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Pustular rash

MedGen UID:
43222
Concept ID:
C0085641
Sign or Symptom
Synonyms: Pustular Rash; Pustulosis
SNOMED CT: Pustular rash (48055004)
 
HPO: HP:0033605

Definition

A rash composed of pustular lesions. A pustule is defined as a vesicle or bulla containing purulent material. It varies in size and may occur at different levels within the epidermis [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPustular rash

Conditions with this feature

STING-associated vasculopathy with onset in infancy
MedGen UID:
863159
Concept ID:
C4014722
Disease or Syndrome
STING-associated vasculopathy with onset in infancy is an autoinflammatory vasculopathy causing severe skin lesions, particularly affecting the face, ears, nose, and digits, and resulting in ulceration, eschar formation, necrosis, and, in some cases, amputation. Many patients have interstitial lung disease. Tissue biopsy and laboratory findings show a hyperinflammatory state, with evidence of increased beta-interferon (IFNB1; 147640) signaling (summary by Liu et al., 2014).
Immunodeficiency 51
MedGen UID:
934770
Concept ID:
C4310803
Disease or Syndrome
Immunodeficiency-51 (IMD51) is an autosomal recessive primary immune deficiency that is usually characterized by onset of chronic mucocutaneous candidiasis in the first years of life. Most patients also show recurrent Staphylococcal skin infections, and may show increased susceptibility to chronic bacterial respiratory infections. Patient cells show a lack of cellular responses to stimulation with certain IL17 isoforms, including IL17A (603149), IL17F (606496), IL17A/F, and IL17E (IL25; 605658) (summary by Levy et al., 2016).
Immunodeficiency 82 with systemic inflammation
MedGen UID:
1781752
Concept ID:
C5543581
Disease or Syndrome
Immunodeficiency-82 with systemic inflammation (IMD82) is a complex autosomal dominant immunologic disorder characterized by recurrent infections with various organisms, as well as noninfectious inflammation manifest as lymphocytic organ infiltration with gastritis, colitis, and lung, liver, CNS, or skin disease. One of the more common features is inflammation of the stomach and bowel. Most patients develop symptoms in infancy or early childhood; the severity is variable. There may be accompanying fever, elevated white blood cell count, decreased B cells, hypogammaglobulinemia, increased C-reactive protein (CRP; 123260), and a generalized hyperinflammatory state. Immunologic workup shows variable B- and T-cell abnormalities such as skewed subgroups. Patients have a propensity for the development of lymphoma, usually in adulthood. At the molecular level, the disorder results from a gain-of-function mutation that leads to constitutive and enhanced activation of the intracellular inflammatory signaling pathway. Treatment with SYK inhibitors rescued human cell abnormalities and resulted in clinical improvement in mice (Wang et al., 2021).
Immunodeficiency 117
MedGen UID:
1848763
Concept ID:
C5882739
Disease or Syndrome
Immunodeficiency-117 (IMD117) is an autosomal recessive immunologic disorder characterized by increased susceptibility to disseminated mycobacterial infection apparent in early childhood. Affected individuals develop mycobacterial disease after BCG (bacille Calmette-Guerin) vaccination and show increased susceptibility to other mycobacterial infections, such as M. avium. Immunologic workup shows impaired development of myeloid and lymphoid cell subsets that secrete and respond to gamma-interferon (IFNG; 147570) (et al., 2023).

Professional guidelines

PubMed

Tetart F, Walsh S, Milpied B, Gaspar K, Vorobyev A, Tiplica GS, Didona B, Welfringer-Morin A, Kucinskiene V, Bensaid B, Marvanova E, Salavastru C, Brezinova E, Chua SL, Lovgren ML, Hammers CM, Barbaud A, Mortz CG, Horvath B, Meyersburg D, Lebrun-Vignes B, Bodemer C, Brüggen MC, French LE, Ingen-Housz-Oro S
J Eur Acad Dermatol Venereol 2024 Nov;38(11):2073-2081. Epub 2024 Jul 18 doi: 10.1111/jdv.20232. PMID: 39023187
Ricci F, Paradisi A, Silveri SL, Sampogna F, Miccichè F, Bonomo PL, DiNapoli N, Valentini V, Capizzi R, Guerriero C
J Dermatolog Treat 2015 Apr;26(2):183-7. Epub 2014 Jun 17 doi: 10.3109/09546634.2014.927815. PMID: 24852820
Cono J, Casey CG, Bell DM; Centers for Disease Control and Prevention
MMWR Recomm Rep 2003 Feb 21;52(RR-4):1-28. PMID: 12617510

Recent clinical studies

Etiology

Lucena-Neto FD, Falcão LFM, Vieira-Junior AS, Moraes ECS, David JPF, Silva CC, Sousa JR, Duarte MIS, Vasconcelos PFC, Quaresma JAS
Viruses 2023 Nov 23;15(12) doi: 10.3390/v15122301. PMID: 38140542Free PMC Article
Ricci F, Paradisi A, Silveri SL, Sampogna F, Miccichè F, Bonomo PL, DiNapoli N, Valentini V, Capizzi R, Guerriero C
J Dermatolog Treat 2015 Apr;26(2):183-7. Epub 2014 Jun 17 doi: 10.3109/09546634.2014.927815. PMID: 24852820
Alexandrescu DT, Kauffman CL, Dasanu CA
Dermatol Online J 2009 Mar 15;15(3):4. PMID: 19379648
Kucharekova M, Winnepenninckx V, Frank J, Poblete-Gutiérrez P
Int J Dermatol 2008 Nov;47 Suppl 1:25-8. doi: 10.1111/j.1365-4632.2008.03954.x. PMID: 18986481
Hutchins SS, Sulemana I, Heilpern KL, Schaffner W, Wax G, Lerner EB, Watson B, Baltimore R, Waltenburg RA, Aronsky D, Coffin S, Ng G, Craig AS, Behrman A, Meek J, Sherman E, Chavez SS, Harpaz R, Schmid S
Clin Infect Dis 2008 Mar 15;46 Suppl 3:S195-203. doi: 10.1086/524383. PMID: 18284359

Diagnosis

De Alwis AC, Lin J
J Paediatr Child Health 2024 Apr-May;60(4-5):154. doi: 10.1111/jpc.1_16413. PMID: 38760911
De Alwis AC, Lin J
J Paediatr Child Health 2024 Apr-May;60(4-5):151. Epub 2023 Apr 13 doi: 10.1111/jpc.16413. PMID: 37052121
Quinn A, Pulsipher K, Szeto M, Presley C, Marroquin N, Dellavalle R
J Drugs Dermatol 2023 Jan 1;22(1):105-106. PMID: 36607751
Lo KBU, Azmaiparashvili Z
Cleve Clin J Med 2019 Dec;86(12):780-781. doi: 10.3949/ccjm.86a.19061. PMID: 31821140
Li Y, Ropp SL, Zhao H, Damon IK, Esposito JJ
J Virol Methods 2007 May;141(2):154-65. Epub 2007 Jan 24 doi: 10.1016/j.jviromet.2006.12.005. PMID: 17254642

Therapy

Daskalakis DC, Heller HM, Shenoy ES, Hsu K
N Engl J Med 2024 May 30;390(20):1906-1912. doi: 10.1056/NEJMcpc2312737. PMID: 38810190
Lo KBU, Azmaiparashvili Z
Cleve Clin J Med 2019 Dec;86(12):780-781. doi: 10.3949/ccjm.86a.19061. PMID: 31821140
Liccioli G, Marrani E, Giani T, Simonini G, Barni S, Mori F
Pharmacology 2019;104(1-2):57-59. Epub 2019 May 8 doi: 10.1159/000500406. PMID: 31067554
Thurman RJ, Hadley ED 3rd
Ann Emerg Med 2016 May;67(5):576-87. doi: 10.1016/j.annemergmed.2015.11.001. PMID: 27106365
Wolf Y, Groutz A, Walman I, Luxman D, David MP
Acta Obstet Gynecol Scand 1995 Mar;74(3):229-32. doi: 10.3109/00016349509008946. PMID: 7900530

Prognosis

Mande G, Akonda I, De Weggheleire A, Brosius I, Liesenborghs L, Bottieau E, Ross N, Gembu GC, Colebunders R, Verheyen E, Ngonda D, Leirs H, Laudisoit A
Int J Infect Dis 2022 Sep;122:647-655. Epub 2022 Jul 7 doi: 10.1016/j.ijid.2022.06.060. PMID: 35809857Free PMC Article
Kirk J, Gunn D, Wong N, Minchin E, Darcy K
Cornea 2020 May;39(5):654-656. doi: 10.1097/ICO.0000000000002225. PMID: 31842040
Littman RJ
Mt Sinai J Med 2009 Oct;76(5):456-67. doi: 10.1002/msj.20137. PMID: 19787658
Kucharekova M, Winnepenninckx V, Frank J, Poblete-Gutiérrez P
Int J Dermatol 2008 Nov;47 Suppl 1:25-8. doi: 10.1111/j.1365-4632.2008.03954.x. PMID: 18986481
Nikkels AF, Nikkels-Tassoudji N, Piérard GE
Eur J Dermatol 1999 Mar;9(2):126-8. PMID: 10066962

Clinical prediction guides

Ricci F, Paradisi A, Silveri SL, Sampogna F, Miccichè F, Bonomo PL, DiNapoli N, Valentini V, Capizzi R, Guerriero C
J Dermatolog Treat 2015 Apr;26(2):183-7. Epub 2014 Jun 17 doi: 10.3109/09546634.2014.927815. PMID: 24852820
Cozzi A, Doria A, Gisondi P, Girolomoni G
J Eur Acad Dermatol Venereol 2014 Jun;28(6):679-88. Epub 2013 Aug 24 doi: 10.1111/jdv.12252. PMID: 23980929
Reddy S, Jia S, Geoffrey R, Lorier R, Suchi M, Broeckel U, Hessner MJ, Verbsky J
N Engl J Med 2009 Jun 4;360(23):2438-44. doi: 10.1056/NEJMoa0809568. PMID: 19494219Free PMC Article
Alexandrescu DT, Kauffman CL, Dasanu CA
Dermatol Online J 2009 Mar 15;15(3):4. PMID: 19379648
Nikkels AF, Nikkels-Tassoudji N, Piérard GE
Eur J Dermatol 1999 Mar;9(2):126-8. PMID: 10066962

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