A Case Report of Generalized Pustular Psoriasis Associated With IgA Nephropathy

Abstract

Psoriasis vulgaris is a complex immune-mediated disorder that manifests as a chronic skin disorder, characterized by well-circumscribed inflammatory, erythematous plaques. In this case report, we present a patient with generalized pustular psoriasis (GPP) who presented to the nephrology department with rapidly progressive decline in renal function. The diagnosis of GPP was made a month ago, secondary to a coagulase-negative staphylococcal superinfection. Intrinsically, this introduced a diagnostic challenge as the presumed diagnosis of immunoglobulin A (IgA) nephropathy had to be distinguished from IgA-dominant infectionrelated glomerulonephritis. We further discuss the current evidence and immunohistological profiles of IgA nephropathy in psoriasis and detail the evolution of renal function of our patient over 25 months after he presented to our department.

Diversity in the clinical presentation of generalized pustular psoriasis (GPP): A series of case vignettes from around the world

“…The patient reported here was re-admitted to hospital for acute renal failure, another common complication associated with systemic inflammation in GPP, 1 week after being discharged. [54][55][56][57] The clinical management of patients with acute renal failure requires a multidisciplinary approach, and treatment should aim to rapidly resolve nephrological symptoms and avoid other systemic complications. It is also important for physicians to consider that some treatments commonly used to treat GPP (e.g., retinoids and cyclosporine) may complicate pre-existing renal conditions and, therefore, may be contraindicated in patients with renal complications.…”

“…Systemic inflammation associated with GPP flares can lead to severe, life‐threatening conditions, including ARDS and congestive heart failure. The patient reported here was re‐admitted to hospital for acute renal failure, another common complication associated with systemic inflammation in GPP, 1 week after being discharged 54–57 . The clinical management of patients with acute renal failure requires a multidisciplinary approach, and treatment should aim to rapidly resolve nephrological symptoms and avoid other systemic complications.…”