A case of pustulosis palmaris et plantaris that began as generalized pustular eruption

A 65-year-old woman suddenly developed a widespread sterile pustular outbreak with high pyrexia. Many pustules appeared on her hands, including both the dorsal and the palmer side, and a few pustule appeared on her trunk and arms in the pattern of acute generalized pustular bacterid. Histopathology of the eruption showed subcorneal pustules. The eruption and pyrexia did not resolve with any of several antibiotics and NSAIDs, but resolved with the oral etretinate. Thereafter, pustules and scaly erythema remained on the arch of the foot and thenar of the palm, typical of pustulosis palmaris et plantaris.