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Amicrobial pustulosis of the folds: Report of 4 cases

Michael Z Wang1, Michael J Camilleri1,2, Ruifeng Guo1

  • 1Department of Dermatology, Mayo Clinic, Rochester, Minnesota.

Journal of Cutaneous Pathology
|December 22, 2016
PubMed

Insights

Amicrobial pustulosis of the folds (APF) is a rare autoimmune skin condition. Recognizing its distinct clinical and histopathologic features aids in diagnosing this aseptic pustular disease.

Area of Science:

  • Dermatology
  • Pathology
  • Autoimmunology

Background:

  • Amicrobial pustulosis of the folds (APF) is a rare condition.
  • It presents as aseptic pustular lesions in skin folds.
  • APF often occurs with autoimmune disorders.

Observation:

  • This study details 4 patients with APF.
  • Clinical and histopathologic features were analyzed.
  • Both intertriginous and extra-intertriginous areas were involved.

Findings:

  • Histopathology revealed neutrophilic inflammation (intracorneal, subcorneal, intraepidermal, perivascular, perifollicular, interstitial).
  • Pustules over adnexal ostia and papillary dermal edema were consistent findings.
  • Microorganisms were absent in pustule stains.

Implications:

  • APF diagnosis requires recognizing specific clinical and histopathologic signs.
  • Associated conditions included connective tissue diseases and autoimmune disorders.
  • Suspicion of APF is warranted in patients with connective tissue disorders exhibiting these features.
Keywords:
amicrobialamicrobial pustulosisautoimmunehistopathologypustulosis

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