Pustular puzzle linked to Crohn’s

We tend to think of pustules as being synonymous with infection – mainly bacterial but also viral and even fungal. However pustules are made up of leukocytes, usually neutrophils and they can be inflammatory rather than infective.

The main inflammatory conditions to consider are pustular drug eruptions, pustular psoriasis, both localised on the palms and soles and generalised and the neutrophilic dermatoses, particularly Sweet’s syndrome and pyoderma gangrenosum.