An arcane presentation of pustular psoriasis in pregnancy: case report

Pustular psoriasis of pregnancy (PPP) also known as impetigo herpetiformis is a well-described dermatosis of pregnancy characterized by the fatal progression of disease for both the mother and the foetus if left untreated. A 28-year-old G2P1L1 pregnant mother at 28 weeks of gestation, came to outpatient department (OPD) with complaints of scaly skin lesions all over her body along with fever, nausea and generalised weakness. On examination, there were erythematous scaly patches in the trunk, back, hands and legs accompanied by formation of pustules in the periphery of the lesions. Histopathological examination was consistent with pustular psoriasis. Patient was managed with prednisolone (40 mg/day which was later tapered). Serial antenatal visits and ultrasounds were done to monitor the health of the mother and foetal growth. Under the support of obstetrician, patient delivered a healthy female baby through caesarean section under general anaesthesia. Her lesions persisted in the postpartum period, which later started reducing gradually.