A Pustular Psoriasis Limited to the Glans Misdiagnosed as Balanitis or Reiter's Syndrome

Abstract

Genital pustular psoriasis is a rare condition characterized by well-demarcated, clear erythematous, absence of the typical scaling which is apparent on non-genital psoriasis. We describe a 30-year-old man with pustular psoriasis limited only to the glans, he was successively misdiagnosed as balanitis, Reiter's syndrome, coinfection of genital herpes and treated with itraconazole, prednisone, valaciclovir respectively, but without control. Skin biopsy was performed, and histopathological examination showed the lesions was consistent with pustular psoriasis. The skin lesions disappeared completely after one-week application of topical corticosteroid and three weeks application of 0.1% tacrolimus. 0.1% tacrolimus was applied for maintenance and there was no recurrence observed hitherto.