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Amicrobial pustulosis of the folds
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Amicrobial pustulosis of the folds

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Contributors: Lauren Croda, Lisa Cotter, Susan Burgin MD
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Synopsis

Amicrobial pustulosis of the folds (APF), also known as amicrobial pustulosis associated with autoimmune disease (APAD), is a rare neutrophilic dermatosis. APF usually occurs in young women and most often is associated with an underlying autoimmune condition. Associated diseases include systemic lupus erythematosus, immune thrombocytopenic purpura, Sjögren syndrome, Hashimoto thyroiditis, and rheumatoid arthritis, among others.

The pustules in APF are sterile, but the lesions can become eroded and secondarily infected. Diagnosis of APF is based largely on clinical presentation and exclusion of other more common diagnoses.

The disease is generally chronic with frequent relapses despite treatment. The disease course of APF does not parallel that of any associated autoimmune disease.

Codes

ICD10CM:
D89.89 – Other specified disorders involving the immune mechanism, not elsewhere classified

SNOMEDCT:
95329006 – Autoimmune skin disease

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Patient history, distribution, negative bacterial and fungal cultures, and negative direct immunofluorescence (DIF) help in the diagnosis of APF.

Other pustular rashes:

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 02/07/2017
Last Updated: 03/29/2017
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Amicrobial pustulosis of the folds
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Amicrobial pustulosis of the folds : Scalp
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