Hypocalcemia-related pustulosis: a case report

Area of Science:

• Dermatology
• Endocrinology
• Internal Medicine

Background:

• Hypocalcemia-related pustulosis is a rare condition presenting as sterile pustules on an erythematous base.
• It is frequently misdiagnosed as generalized pustular psoriasis, complicating patient management.
• Recognizing hypocalcemia as a cause of pustular eruptions is key for effective treatment.

Purpose of the Study:

• To highlight the association between hypocalcemia and pustular eruptions.
• To emphasize the diagnostic challenges and importance of electrolyte evaluation.
• To demonstrate the therapeutic efficacy of calcium correction in such cases.

Main Methods:

• A case study of a 34-year-old woman with hypoparathyroidism presenting with generalized pustular eruption.
• Diagnostic workup included laboratory tests confirming severe hypocalcemia and a skin biopsy excluding psoriasis.
• Treatment involved calcium and vitamin D supplementation.

Main Results:

• The patient exhibited severe hypocalcemia (52 mg/L) and low parathyroid hormone levels.
• Skin biopsy ruled out psoriasis, supporting a diagnosis of hypocalcemia-induced pustulosis.
• Pustular eruption resolved dramatically within 24 hours of treatment initiation and cleared completely over days.

Conclusions:

• Investigating electrolyte imbalances, especially hypocalcemia, is crucial for unexplained pustular eruptions.
• Prompt calcium correction leads to rapid and complete resolution of skin lesions.
• Early diagnosis and management of hypocalcemia are vital for patient recovery.