Back issues No.4 - 1999 / Case Report  

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Acute Respiratory Distress Syndrome Complicating Generalized Pustular Psoriasis
Pa-Fan Hsiao, Hsin-Yi Su, Chien-Liang Wu, Hsiu-Chin Chen
Dermatol Sinica 17: 364-369, 1999

Acute respiratory distress syndrome (ARDS) has rarely been reported as a serious complication of generalized pustular psoriasis. Only seven cases have been described in the medical literature and four of these cases were fatal. We describe a 64-year-old woman with generalized pustular psoriasis who later developed ARDS during hospitalization. This patient with a more than 10 year history of psoriasis vulgaris was admitted due to a widespread pustular eruption. She suddenly developed tachypnea and hypoxemia on the sixth day after admission. Chest radiography showed pulmonary edema and echocardiography confirmed normal left ventricular function. Repeated blood cultures and sputum cultures were all negative for organisms. Her hypoxemia status improved after ventilatory support and her skin condition was controlled with etretinate therapy. Although generalized pustular psoriasis complicated by ARDS is rare, physicians caring for patients with psoriasis should be aware of this potentially serious complication.

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