Authors:Jarische Frances S. Lao-Ang, MD, Ma. Lourdes Nebrida-Idea, MD, FPDS; and Ma. Lorna F. Frez, MD, FPDS
Introduction: Sneddon-Wilkinson disease (SWD) is a rare, recurrent neutrophilic dermatosis presenting as sterile pustules, with a predilection for flexural and intertriginous areas.
Case summary: A 49-year-old Filipino female presented with a three-year history of recurrent pustules and papules on the flexural areas of trunk and extremities. Skin punch biopsy was done and histopathology was consistent with subcorneal pustular dermatosis/SWD. She was started on Dapsone but after two weeks of intake, the patient developed generalized erythematous desquamating plaques on the trunk and extremities, with palmoplantar involvement. The patient did not have fever, jaundice, lymphadenopathy, and abdominal tenderness. Laboratory investigation such as complete blood count and liver function tests were normal. The final diagnosis was SWD with hypersensitivity to Dapsone. Dapsone was immediately discontinued and she was shifted to oral colchicine. After six weeks of oral colchicine therapy, the lesions have completely resolved. Patient was in remission for six months thereafter.
Conclusion: SWD is rare and the drug of choice is dapsone. In instances where dapsone is not suitable, oral
colchicine can be an ideal alternative treatment.
Sneddon-Wilkinson disease; dapsone; colchicine
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