Acute Respiratory Distress Syndrome and Generalized Pustular Psoriasis: Another Case Report

Systemic involvement of acute generalized exanthematous pustulosis: a retrospective study on 58 patients

“…23 In addition to their antibacterial and antimycotic defence roles, Th17 cells are key actors in the regulation of inflammation by recruiting neutrophils to inflammatory sites by stimulating keratinocytes to produce CXCL8. [29][30][31][32] In those case reports, neutrophil involvement was not proven histologically, and the pathogenesis was unknown. epithelial cells in mucosal tissues and keratinocytes.…”

Acute respiratory distress syndrome complicating generalized pustular psoriasis (psoriasis-associated aseptic pneumonitis)

“…Four patients died within the first 3 months. 4,6,8 Of note, our patient experienced cardiac arrest after catheter removal, presumably related to an air embolism. Several other cases of cardiac arrest have been reported as well, but the link between interstitial pneumopathy and cardiac arrest remains to be determined as patients deteriorate quickly and require transfer to an intensive care unit.…”

“…Since then, several cases of noninfectious acute respiratory distress syndrome in the context of generalized pustular psoriasis and/or erythroderma have been reported in the literature. [2][3][4][5][6][7][8][9][10] Earlier reports mention ''capillary leak syndrome'', 3,5,6 whereas most recent reports use the term ''acute distress respiratory syndrome.'' [7][8][9][10] However, in all cases the syndromes are the same disease affecting only the lung.…”

“…1 Noninfectious acute respiratory distress syndrome (termed "sterile pneumonitis" by Landry and Muller 2 in 1972) in generalized pustular psoriasis and/or erythrodermic psoriasis is an exceptional complication that has rarely been reported in the literature. [2][3][4][5][6][7][8][9][10] Dermatologists should be aware of the condition, however, as the differential diagnoses include congestive heart failure, acute lung infection related or unrelated to immunosuppressive therapy, and drug hypersensitivity reaction. Early diagnosis would ensure that this potentially lethal complication is correctly managed, notably with high-dose systemic corticosteroid therapy.…”

Systemic Toxicity Following Administration of Sirolimus (Formerly Rapamycin) for Psoriasis

“…24 Capillary leak syndromes have been reported previously among patients with severe psoriasis. [36][37][38][39][40] In 5 of 7 patients, a systemic therapy (etretinate in 4 and methotrexate in 1) was begun shortly before the syndrome developed; in the other 2 cases, the timing of the syndrome in relation to the patients' etretinate and cyclosporine therapies is not clear. All of these therapeutic agents induce cell apoptosis in certain situations, [41][42][43][44][45] and retinoids and cyclosporine have been associated with capillary leak syndrome in subjects without psoriasis.…”