Pustulosis exantemática generalizada aguda inducida por antiinflamatorios no esteroideos: Reporte de caso

Abstract

Introduction: Acute Generalized Pustular Psoriasis is a rare skin disease characterized by the sudden appearance of tiny, sterile, non-follicular pustules on an erythematous and edematous base. It primarily affects women, with most reported cases having been attributed to antibiotics use; however, in this case, non-steroidal anti-inflammatory drugs triggered it. Pathogenesis involves CD4 and CD8 T lymphocytes, which contribute to the formation of vesicles and pustules. Symptoms include itching, fever, leukocytosis, and biochemical abnormalities. Diagnosis is based on clinical history, physical examination, and biopsy. The main treatment consists of eliminating the causal agent and supportive measures, with spontaneous resolution occurring within 1 to 2 weeks. Case presentation: A case of Acute Generalized Pustular Psoriasis is presented in a 50-year-old female patient who developed generalized erythematous pustules after receiving intramuscular diclofenac, with a biopsy confirming the diagnosis, and treatment initiated with the biological drugs (infliximab). Conclusions: This work demonstrates how drug-induced skin reactions can occur with unusual medications, such as non-steroidal anti-inflammatory drugs. Additionally, it highlights how treatment with biological drugs achieved better results compared to conventional treatment.