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Subcorneal spongiform pustules containing numerous neutrophils.
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Figure 2: Subcorneal spongiform pustules containing numerous neutrophils.

Mentions: Intravenous fluids, oral prednisone 60 mg/d, calcium gluconate 2 g/d, Calcitrol 0.25 μg/d, intravenous clindamycin 1200 mg/d and intravenous vancomycin 1 g/day were given. The correction of hypocalcaemia (within five days) was accompanied with rapid improvement of her skin disease and general condition, indicating the importance of correction of hypocalcaemia in patients with impetigo herpetiformis precipitated by hypoparathyroidism [1]. The skin biopsy was consistent with pustular psoriasis. (Figure 2)

Impetigo herpetiformis during the puerperium triggered by secondary hypoparathyroidism: a case report

Fouda UM, Fouda RM, Ammar HM, Salem M, Darouti ME - Cases J (2009)

Bottom Line: The patient was treated with intravenous fluids, calcium, Calcitrol and corticosteroids.The correction of hypocalcaemia was accompanied with rapid improvement of her skin disease and general condition.The awareness of the possible occurrence of impetigo herpetiformis during the puerperium allows early diagnosis, treatment and prevention of maternal complications.

Affiliation: Department of Obstetrics & Gynecology, Cairo University, Kasr Al Aini Street, Cairo, Egypt.

ABSTRACT
A 38-year-old multiparous woman with post thyroidectomy hypoparathyroidism developed pruritic erythematous patches with multiple pustules on its margins on her thighs and groin accompanied by fever few days after delivery by caesarean section. Impetigo herpetiformis was diagnosed based on the typical clinicopathological findings. The patient was treated with intravenous fluids, calcium, Calcitrol and corticosteroids. The correction of hypocalcaemia was accompanied with rapid improvement of her skin disease and general condition. Our case is the fourth case of impetigo herpetiformis initially presented during puerperium and the first case of puerperal impetigo herpetiformis that is precipitated by secondary hypoparathyroidism. The awareness of the possible occurrence of impetigo herpetiformis during the puerperium allows early diagnosis, treatment and prevention of maternal complications.

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