Evaluation of pustular rash

Diseases

Summary

A pustule is a vesicle or bulla containing purulent material. It varies in size and may occur at different levels within the epidermis: subcorneal, intraepidermal, or basement membrane zones. A pustular rash is composed of multiple pustular lesions. The pustules may or may not be sterile and are normally filled with neutrophils.

When the pus is contained within the dermis, the lesion is called an abscess or furuncle. If it is deep and dissects through tissue planes it is called a carbuncle.

This topic covers purely pustular rashes and vesicular eruptions that develop into pustular rashes.

Library

Neonate with bullous impetigo
Superficial folliculitis with prominent erythematous papules and pustules
Secondary syphilitic lesions on the face
Infant presenting with rash formerly known as moniliasis, now called candidiasis, caused by Candida spp
Tinea manuum. On the extensor surface of the hand there is extensive inflammation, scaling, hyperkeratosis, and erythema
Tinea corporis of the axilla. Central clearing with an active border of inflammation noted. Satellite lesion is present
Tinea barbae. Note the pustules in the follicles, redness, and scaling
Tinea pedis. Intense inflammation produces hyperpigmentation and vesicle formation. Vesiculobullous form of tinea pedis
Scabies: characteristic linear burrows in skin
Nodulocystic acne
Mouth and genital ulcers in Behcet disease
Pseudopustule formation following fire ant sting
Miliaria rubra
Rosacea fulminans
Pustules in a patient with reactive arthritis

Citations

Key Articles

Ramakrishnan K, Salinas RC, Agudelo Higuita NI. Skin and soft tissue infections. Am Fam Physician. 2015 Sep 15;92(6):474-83.[Abstract][Full Text]
Mengesha YM, Bennett ML. Pustular skin disorders: diagnosis and treatment. Am J Clin Dermatol. 2002;3:389-400.[Abstract]
Conlon JD, Drolet BA. Skin lesions in the neonate. Pediatr Clin North Am. 2004;51:863-388, vii-viii.[Abstract]

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