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Pustular Eruptions

»	How does a pustule differ from a vesicle or bulla?
»	How are pustules classified?
»	What is the most common pustular skin eruption?
»	Name the different types of pustular psoriasis. How do they differ?
»	Do any factors precipitate generalized pustular psoriasis?
»	Is pustular psoriasis treated differently than classic plaque-type psoriasis?
»	What is pustular bacterid?
»	Why do some consider pustular bacterid a form of localized pustular psoriasis of the palms and soles?
»	What is subcorneal pustular dermatosis (Sneddon-Wilkinson disease)?
»	Discuss the pathogenesis of subcorneal pustular dermatosis.
»	How is subcorneal pustular dermatosis treated?
»	What is superficial IgA pemphigus?
»	What are the cutaneous findings in reactive arthritis (Reiter’s disease)?
»	Which drugs are commonly associated with pustular drug eruptions?
»	What is acne necrotica miliaris?
»	What is folliculitis decalvans?
»	Discuss the pathogenesis of miliaria pustulosa.
»	How is miliaria pustulosa treated?
»	What is the differential diagnosis of a pustular eruption in a neonate?
»	How do erythema toxicum neonatorum and transient neonatal pustular melanosis differ?
»	What is infantile acropustulosis?
»	What causes infantile acropustulosis?
»	What is the best treatment of infantile acropustulosis?

How are pustules classified?

Pustules may be classified on the basis of where the acute inflammatory cells accumulate (e.g., subcorneal, follicular), pathogenesis (e.g., infectious, autoimmune), predominant inflammatory cells (e.g., neutrophils, eosinophils), and clinical presentation (Table 11-1). Pustules may be unilocular or multilocular.

Table 11-1. Classification of Pustules
	PATHOGENESIS	SITE OF ACCUMULATION
	Autoimmune
	IgA pemphigus	Subcorneal
	Infectious
	Arthropod reactions	Intraepidermal
	Candidiasis	Subcorneal
	Furuncle/carbuncle	Follicular
	Impetigo	Subcorneal
	Hot tub (pseudomonal) folliculitis	Follicular
	Kerion (tinea capitis)	Follicular
	Pityrosporum folliculitis	Follicular
	Vaccinia infection/vaccination	Intraepidermal
	Inherited
	Pustular psoriasis	Subcorneal, intraepidermal
	Reiter’s syndrome	Subcorneal, intraepidermal
	Drug eruptions
	Acneiform drug-induced eruptions	Follicular
	Toxic erythema with pustules	Subcorneal
	Halogenodermas	Intraepidermal
	Miscellaneous
	Acne necrotica miliaris	Follicular
	Acne vulgaris	Follicular
	Erythema toxicum neonatorum	Follicular
	Folliculitis decalvans	Follicular
	Infantile acropustulosis	Subcorneal, intraepidermal
	Miliaria pustulosa	Sweat duct
	Pustular bacterid	Intraepidermal
	Rosacea	Follicular
	Subcorneal pustular dermatosis	Subcorneal
	Transient neonatal pustular dermatosis	Subcorneal