Subcorneal Pustular Dermatosis (Sneddon Wilkinson Disease) in a patient with Rheumatoid Arthritis

Abstract

Subcorneal pustular dermatosis or Sneddon Wilkinson’s disease is a rare entity, with unknown prevalence and incidence because it is underdiagnosed. It is characterized by soft sterile pustules with preferential location on the trunk and flexural regions such as the armpits and groin. The lesions can sit on healthy skin but are often found within a red patch. The pustules resolve in a few days and are replaced by fine scales before there is another relapse and new pustules form. Lesions may be pruritic, but are generally asymptomatic. It can get worse for a few weeks and then go away for months or years before reappearing. The process can be repeated for many years. 

We present the case of a 43-year-old male with a history of rheumatoid arthritis with dermatosis in flexural regions characterized by pustules, which was initially diagnosed as pustular psoriasis.