Metabolic and Ultrastructural Studies in a Patient With Pustular Psoriasis (von Zumbusch)

Braverman, Irwin M.

doi:10.1001/archderm.1972.01620050003001

Cited by 53 publications

(17 citation statements)

References 31 publications

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“…Although cutaneous involvement is always the predominant feature, extracutaneous localizations have also been described, and liver involvement has only been reported in isolated cases prior to this study. [5][6][7][8][17][18][19][20][21][22][23] However, the incidence of liver damage has not been previously investigated in published series of patients with GPP. 1,2,24 -27 The results presented herein provide evidence for a high frequency of liver involvement in patients with GPP.…”

Section: Discussionmentioning

confidence: 99%

“…5,6,8,[17][18][19][20][21][22][23] The hypothesis that liver abnormalities in patients with GPP could be related to the inflammatory pathogenic process characterized by a predominant neutrophilic activation has already been raised by several authors. 5,6,8 In the reported cases, ultrasonography, tomodensitometry explorations, 5,8,22 ERCP, 8 or MRCP 22 showed no significant change.…”

Section: Discussionmentioning

confidence: 99%

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High frequency of cholestasis in generalized pustular psoriasis: Evidence for neutrophilic involvement of the biliary tract

et al. 2004

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Generalized pustular psoriasis is a rare form of psoriasis that is sometimes associated with extracutaneous manifestations. Evidence for biliary involvement has been suggested in isolated cases. We investigated the prevalence and nature of liver abnormalities occurring in this disease. Twenty-two patients consecutively admitted for generalized pustular psoriasis who underwent liver biological tests at the time of the attack and during the following weeks were included. Twenty patients (90%) had at least one abnormal biological liver parameter. Eleven patients (50%) had pronounced abnormalities: jaundice (4/22), gammaglutamyl transferase higher than 5 times the normal value (10/22), alkaline phosphatase higher than twice the normal value (7/22), and/or aminotransferases higher than 3 times the normal value (7/22). These abnormalities returned to normal range at the time of remission of pustular psoriasis, suggesting that severe liver abnormalities could be associated with severe cutaneous disease. Neutrophilic cholangitis was observed on liver biopsy. Persistent magnetic resonance cholangiopancreatography features similar to those observed in sclerosing cholangitis were found in 3 of the 4 patients studied. No causal factor other than pustular psoriasis could be identified. In conclusion, our results demonstrate the high frequency of liver abnormalities in patients with generalized pustular psoriasis. Biliary involvement related to neutrophilic cholangitis should be added to the spectrum of extracutaneous manifestations of this disease, and physicians should be aware of such a complication. (HEPATOLOGY 2004;40:452-458.)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

High frequency of cholestasis in generalized pustular psoriasis: Evidence for neutrophilic involvement of the biliary tract

et al. 2004

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“…Their role is not completely understood, however, they may be responsible in part for the known increased transcapillary loss of albumin and other plasma proteins in extensive psoriasis 5–7 . To a lesser extent the continuous capillaries of normal skin are also replaced in plaque skin by fenestrated capillaries which are an order of magnitude more permeable to water and hydrophilic solutes than most continuous capillaries 1,3,8,9 . What causes the appearance of these fenestrae is not clear.…”

mentioning

confidence: 99%

In vivo quantification of microvessels in clinically uninvolved psoriatic skin and in normal skin

Hern

Mortimer

2007

Br J Dermatol

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These findings indicate that prior to the development of clinical lesions there are no significant morphological differences between the dermal microvessels in the clinically uninvolved skin of psoriatic subjects and the dermal microvessels in the normal skin of healthy volunteers. However, during plaque formation, the superficial papillary microvessels in plaque skin undergo a striking, characteristic change, i.e. elongation, widening and tortuosity. These blood vessels must therefore, at least in part, play an important, necessary, but probably secondary role in the pathogenesis of clinical lesions in psoriasis.

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“…Only a few cases of scarring alopecia have been reported associated with GPP [4,5], and, to our knowledge, cases showing alopecia totalis in association with GPP have not been previously reported. Alopecia occurs as a result of scalp involvement in GPP [6].…”

mentioning

confidence: 72%

Alopecia universalis Associated with Zumbusch-Type Generalized Pustular Psoriasis

Miyazaki¹,

Yamamoto²,

Watanabe³

et al. 2002

Dermatology

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Metabolic and Ultrastructural Studies in a Patient With Pustular Psoriasis (von Zumbusch)

Cited by 53 publications

References 31 publications

High frequency of cholestasis in generalized pustular psoriasis: Evidence for neutrophilic involvement of the biliary tract

High frequency of cholestasis in generalized pustular psoriasis: Evidence for neutrophilic involvement of the biliary tract

In vivo quantification of microvessels in clinically uninvolved psoriatic skin and in normal skin

Alopecia universalis Associated with Zumbusch-Type Generalized Pustular Psoriasis

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