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Successful Treatment of Subcorneal Pustular Dermatosis (Sneddon-Wilkinson Disease) by Acitretin: Report of a Case

We report a case of subcorneal pustular dermatosis (SPD) first treated with dapsone with poor response. Dapsone was changed to acitretin, which dramatically improved the lesions in a few days. Dapsone is the first-line treatment in SPD, but it may be ineffective in some cases and its toxicity is important. Therapeutic alternatives are limited and less effective (systemic corticosteroids, phototherapy). Our observation underlines the usefulness of retinoids, when dapsone is ineffective or poorly tolerated. Their effectiveness is comparable, but they are effective more rapidly and are better tolerated. A dose maintenance is necessary to avoid relapses. Their action in SPD remains unclear but may be due to the inhibition of neutrophil functions.