Inflammatory pustules spell psoriasis

The first instinct may be to call it a fungal infection because of the site. The important feature to notice is the presence of pustules, which in this case are inflammatory rather than infective.

This is localised pustular psoriasis where neutrophils invade the epidermis and form pustules under the thin stratum corneum. A differential diagnosis would be infected pompholyx eczema but the vesicles would have had clear fluid in them first, later becoming turbid. Swabs and scrapings would test negative.

Treat this with a strong topical steroid cream even under cling wrap occlusion at night for

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