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Gastrointestinal bleeding with severe mucosal involvement in a patient with generalized pustular psoriasis without IL 36 RN mutation
Author(s) -
Komatsuda Shiori,
Kamata Masahiro,
Chijiwa Chika,
Namiki Kaoru,
Fukaya Saki,
Hayashi Kotaro,
Fukuyasu Atsuko,
Tanaka Takamitsu,
Ishikawa Takeko,
Ohnishi Takamitsu,
Abe Koichiro,
Yamamoto Takatsugu,
Aozasa Naohiko,
Sugiura Kazumitsu,
Tada Yayoi
Publication year - 2019
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.14711
Subject(s) - generalized pustular psoriasis , medicine , psoriasis , erythema , lesion , mutation , dermatology , skin lesion , pathogenesis , arthritis , gastrointestinal bleeding , pathology , gastroenterology , immunology , gene , biology , genetics
Generalized pustular psoriasis ( GPP ) is a systemic inflammatory disease that presents with erythema and sterile pustules, pathologically characterized by Kogoj's spongiform pustules. GPP is sometimes accompanied by mucosal involvement, and the most common lesion is on the tongue. IL 36 RN mutation was found to contribute to the pathogenesis of GPP especially in patients who develop GPP without a past medical history of psoriasis vulgaris. The association of IL 36 RN mutation with mucosal involvement in GPP is controversial. We herein report a 60‐year‐old male GPP patient with no past history of plaque psoriasis presenting with not only severe skin lesions and arthritis but also severe mucosal involvements of pharyngeal and gastrointestinal lesions, which led to gastrointestinal bleeding. Our case did not have any mutation in the IL 36 RN gene. We should be aware that severe GPP can cause gastrointestinal bleeding. The relevancy of IL 36 RN mutation with mucosal involvement in GPP remains to be elucidated.