Abstract
A 35-year-old woman at 35 weeks of pregnancy presented our hospital complaining of pruritic erythemas and papulovesicles over her legs and trunk. Under the diagnosis of autosensitization dermatitis, we treated her with an ointment of beclometasone dipropionate, which, however, did not releave her symptoms. Then we treated her with a stronger glucocorticoid ointment, diflorasone diacetate, but this resulted in conversion of preexisting lesions to exudative erythemas mounted with groupings and annular arrangement of pustules. Histopathologic examination of the lesions revealed elongation of the rete ridges of the epidermis, spongiform pustule of Kogoj, which characterizes the feature of pustular psoriasis. We made a diagnosis of “impetigo herpesformis-like pustulosis” converted from eczematous lesions, since she had no systemic symptoms such as chills or fever. She was given an oral anti-histamine, azelastine hydrochloride, and topically treated with betamethasone valerate/gentamicin sulfate, by which all the pruritic erythemas and pustules subsided in ten days. Thus, we suggest that a transient, impetigo herpesformis-like pustulosis may develop in a pregnant woman when treated with the strongest class of glucocorticoid through its action of neutrophil mobilization.
