Face Pustules

 If there are Pustules then the mnemonic is II
(aye aye) Infective( viral, bacterial, fungal) or Inflammatory eg psoriasis or a pustular drug reaction or Sweet's syndrome or Erosive pustular dermatosis scalp. Common causes include Staph folliculitis , modified fungal infection or if the vesicles are grouped herpes simplex. Pustules on the face are Acne, Rosacea, Staph folliculitis or H Simplex if grouped

Face and Pustules

 

Pustules on the face are usually due to staphylococcal infection with a staph folliculitis or impetigo.  Acne is the commonest cause in adolescents.  Pustules at the edge of a spreading scaly area suggest steroid modified tinea infection with steroid withdrawal.  Pustules and flushing are commonly part of rosacea.Grouped pustules on the face particularly around the lips is herpes simplex.

 

Management-Swab for viral and bacterial culture.Take scrapings for fungus,

 

SIGN DIP

S Squamous Tinea corporis, Subcorneal pustular dermatosis, Pustular psoriasis, Acrodermatitis enteropathica

I Infective  Staphylococcal infection, Herpes simplex, Herpes zoster, Varicella, Candidiasis, Fungal septicaemia (Candida,mucor and cryptococcus), Secondary syphilis, Gonococcemia, Pseudomonas septicemia

G Granulomatous

N Neoplastic Necrolytic migratory erythema

D Drug    Bromides,iodides , norfloxacin, carbamazepine , amoxycillin,

I Immunological  Atopic eczema, Nummular eczema, Seborrhoeic eczema, Contact dermatitis, Dermatitis herpetiformis, Ofugi's disease (Eosinophilic pustular folliculitis0

P Physical  Miliaria, Swimmers itch

 

Pustules on the abdomen suggests folliculitis but it may be pseudomonas rather than staphylococci.Most pustules are infective eg Tinea corporis,Pityrosporon folliculitis and Varicella but some are inflammatory. Spreading pustules originating in the groin and spreading out onto the abdomen suggest tinea cruris first but then disorders such as necrolytic migratory erythema, Sneddon Wilkinson disease or subcorneal pustular dermatosis or even acrodermatitis enteropathica.

Widespread Pustules in a Neonate -Pustular miliaria, Torch syndrome, Transient neonatal pustular melanosis, Incontinentia Pigmenti, Congenital varicella, Toxic erythema neonatorum, Letter-Siwe disease(Histiocytosis), Infantile acropustulosis, syphilis.

Pustules and Arthralgia -Gonnococcemia, Acne fulminans, Moxarella bacteremia, Chronic meningococcemia, Subcute bacterial endocarditis, Bowel associated arthritis syndrome, Behcet's syndrome, Hand foot and mouth disease.