SUBCORNEAL PUSTULAR DERMATOSIS
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I have a 60 year old man with subcorneal 
pustular dermatosis, biopsy confirmed. He does not have a paraproteinemia, 
and enjoys good health. He has a deficiency of G6PD, and cannot tolerate 
Dapsone. His disease doesn't improve on oral steroids ( I tried 30 mg of 
prednisone for one week, but the condition worsened). I have just started 
colchicine.
Does anyone have experience or ideas?

Dr.Annette Wegman
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I have a lady with only a few lesions of subcorneal pustular dermatosis 
confined to the lower extremities. Since it is not widespread, I have managed 
to temporize with intralesional steroids (2.5-5.0 mg/cc) or even Temovate gel. 

Jerry Eisner MD
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I'd probably try tegison 50-75/day first and methotrexate later if tegison
doesn't do the job.  

Guy Webster MD
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I would consider etretinate 25-75 mg QD. Also, what was the reaction to
dapsone , and is the G6PD deficiency a relative, severe, absolute problem?
This or sulfapyridine +/- etretinate could work well as I have seen in a
couple of patients with low G6PD.

David J. Altman, MD, PhD
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