<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-1249</journal-id>
<journal-title><![CDATA[Archivos de Pediatría del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Arch. Pediatr. Urug.]]></abbrev-journal-title>
<issn>1688-1249</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Uruguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-12492025000301311</article-id>
<article-id pub-id-type="doi">10.31134/ap.96.28</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Psoriasis pustulosa generalizada en la Infancia]]></article-title>
<article-title xml:lang="en"><![CDATA[Generalized pustular psoriasis in childhood]]></article-title>
<article-title xml:lang="pt"><![CDATA[Psoríase pustulosa generalizada em crianças]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cedrés]]></surname>
<given-names><![CDATA[Liliana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Notejane]]></surname>
<given-names><![CDATA[Martín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castañola]]></surname>
<given-names><![CDATA[Mariana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acosta]]></surname>
<given-names><![CDATA[Agustina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[Loreley]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,UDELAR Facultad de Medicina Unidad Académica Pediatría B]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,UDELAR Facultad de Medicina Unidad Académica Pediatría B]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,UDELAR Facultad de Medicina ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,UDELAR Facultad de Medicina Unidad Académica Dermatología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,UDELAR Facultad de Medicina Unidad Académica Pediatría B]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>96</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-12492025000301311&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-12492025000301311&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-12492025000301311&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  la psoriasis pustulosa generalizada (PPG) es una forma rara de psoriasis en la infancia que se presenta con pústulas neutrofílicas asépticas. La extensión de las lesiones y el compromiso sistémico le otorgan gravedad variable. Su diagnóstico es clínico y de confirmación anatomopatológica.  Objetivos:  describir el abordaje diagnóstico y terapéutico de una niña con PPG y compartir las interrogantes respecto a la etiología de la afectación hepática identificada.  Caso clínico: 8 años, sin antecedentes patológicos, consultó por lesiones de piel tipo placas descamativas y pruriginosas en la cara, cuello y tronco. Sin compromiso mucoso, sin fiebre. Se interpretó como dermatitis atópica sobreinfectada. Peoría clínica bajo tratamiento. Las placas se tornan eritematosas, con pústulas en su interior, extendiéndose a miembros. Con planteo de PPG, ingresó al hospital. Anatomía patológica confirma la dermatitis pustular subcorneal. En la evolución: regular estado general, peoría de las lesiones, eritrodermia y fiebre. Leucocitosis. Cultivo de piel y hemocultivos sin desarrollo. Se inició tratamiento con retinoide (acitretina), mejoría de las lesiones. Al tercer día, aumento de transaminasas hepáticas. Se suspendió la acitretina por sospecha de efecto adverso. Alta a los 20 días, mejoría clínica y paraclínica. Un mes después, nuevo empuje sin compromiso sistémico. Se reinstaló acitretina, con buena evolución.  Conclusiones:  la baja frecuencia de la PPG puede llevar al retraso diagnóstico. Este caso presentó compromiso hepático como manifestación sistémica inicial. La duda de que esta presentación se tratara de un efecto adverso grave al retinoide confundió a los clínicos y obligó a realizar cambios terapéuticos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Summary:  Introduction:  generalized pustular psoriasis (GPP) is a rare form of psoriasis in childhood characterized by aseptic neutrophilic pustules. The extent of the lesions and systemic involvement give variable severity. Its diagnosis is clinical and confirmed by histopathology.  Objectives: describe the diagnostic and therapeutic approach of a girl with GPP and share the questions regarding the etiology of the identified liver involvement.  Clinical case:  8 years old, with no pathological history, consulted for skin lesions such as scaly and pruritic plaques on the face, neck and trunk. No mucosal involvement, no fever. It was interpreted as infected atopic dermatitis. Clinical worsening under treatment. The plaques become erythematous, with pustules inside, spreading to the limbs. Referred by the GPP, she was admitted to hospital. Pathology anatomy confirmed subcorneal pustular dermatitis. In the evolution: regular general condition, worsening of the lesions, erythroderma and fever. Leukocytosis. Skin and blood culture without development. Treatment with retinoid (acitretin) was started, the lesions improved. On the third day, increase in liver transaminases. Acitretin was discontinued due to the suspicion of adverse effects. Discharged after 20 days, clinical and paraclinical improvement. A month later a new push without systemic commitment. Acitretin was reinstated, with positive progress.  Conclusions: the low frequency of GPG can lead to diagnostic delay. This case presented liver involvement as the initial systemic manifestation. The doubt that this presentation was a serious adverse effect of the retinoid confused clinicians and led to therapeutic changes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução: a psoríase pustulosa generalizada (PPG) é uma forma rara de psoríase na infância que se apresenta com pústulas neutrofílicas assépticas. A extensão das lesões e o comprometimento sistêmico conferem-lhe gravidade variável. O seu diagnóstico é clínico e de confirmação anatomopatológica.  Objetivos: descrever a abordagem diagnóstica e terapêutica de uma menina com PPG e compartilhe as questões relacionadas à etiologia do envolvimento hepático identificado.  Caso Clínico: criança de 8 anos, sem antecedentes patológicos, consultou por lesões de pele tipo placas descamativas e pruriginosas no rosto, pescoço e tronco. Sem comprometimento mucoso, sem febre. Foi interpretado como dermatite atópica superinfectada. Há uma piora clínica sob tratamento. As placas tornaram-se eritematosas, com pústulas em seu interior, estendendo-se aos membros. Com suspeita de PPG, ela foi internada no hospital. A anatomia patológica confirmou a dermatite pustulosa subcórnea. Na evolução: estado geral regular, piora das lesões, eritrodermia e febre. Leucocitose. Cultura de pele e hemoculturas sem crescimento. Iniciou-se tratamento com retinoide (acitretina), com melhora das lesões. No terceiro dia, aumento das transaminases hepáticas. A acitretina foi suspensa por suspeita de efeito adverso. Alta aos 20 dias, com melhora clínica e paracliníca. Um mês depois, novo surto sem comprometimento sistêmico. A acitretina foi reinstalada, com boa evolução.  Conclusões: a baixa frequência da PPG pode levar ao atraso diagnóstico. Este caso apresentou comprometimento hepático como manifestação sistêmica inicial. A dúvida de que esta apresentação se tratava de um efeito adverso grave ao retinoide confundiu os clínicos e obrigou a realizar mudanças terapêuticas.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Psoriasis]]></kwd>
<kwd lng="es"><![CDATA[Niño]]></kwd>
<kwd lng="en"><![CDATA[Psoriasis]]></kwd>
<kwd lng="en"><![CDATA[Child]]></kwd>
<kwd lng="pt"><![CDATA[Psoríase]]></kwd>
<kwd lng="pt"><![CDATA[Criança]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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