Bilateral periocular psoriasis: an initial manifestation of acute generalized pustular psoriasis with coexistent Sjögren's syndrome
Article first published online: 8 NOV 2007
Clinical & Experimental Ophthalmology
Volume 35, Issue 8, pages 763–766, November 2007
How to Cite
Fernandes, M., Vemuganti, G. K. and Rao, G. N. (2007), Bilateral periocular psoriasis: an initial manifestation of acute generalized pustular psoriasis with coexistent Sjögren's syndrome. Clinical & Experimental Ophthalmology, 35: 763–766. doi: 10.1111/j.1442-9071.2007.01581.x
- Issue published online: 8 NOV 2007
- Article first published online: 8 NOV 2007
- Received 14 March 2007; accepted 28 June 2007.
- dry eye;
- ocular psoriasis;
- pustular psoriasis;
- Sjögren's syndrome
A 21-year-old febrile lady presented to the emergency service with severe lid oedema, conjunctivitis, dry mouth and abdominal skin rash. Over 5 days, she developed silvery scales and pustules on the lids, and generalized pustules on an erythematous base. Multiple focal sterile corneal infiltrates were seen. Haematological investigations and a skin biopsy were done as the consulting dermatologist suspected acute generalized pustular psoriasis. In addition, secondary Sjögren's syndrome was diagnosed since she had keratoconjunctivitis sicca, xerostomia, raised erythrocyte sedimentation rate and positive antinuclear antibodies. The presence of microabscesses in the epidermis on skin biopsy confirmed the diagnosis of pustular psoriasis. With oral methotrexate 7.5 mg weekly and topical corticosteroids, the acute condition gradually resolved; however, the keratoconjunctivitis sicca is persisting. Secondary Sjögren's syndrome associated with acute generalized pustular psoriasis and ocular psoriasis is extremely rare. Awareness of the ocular and dermatological features of these two conditions would result in earlier diagnosis and institution of appropriate treatment.