Ingestion of Topical Steroid Triggering Pustular Psoriasis?

In 2005, a 7-year-old girl with a family history of psoriasis developed generalized pustular psoriasis (GPP), von Zumbusch type, after accidentally ingesting a large quantity of clobetasone butyrate, a topical steroid. This incident resulted in a significant dose of steroid for her body size. Her condition deteriorated despite initial treatments, necessitating hospitalization. The diagnosis of GPP was confirmed by her family history, the swift onset of symptoms post-ingestion, and associated hair loss. She responded well to ciclosporin treatment, showing dramatic improvement within a week. This case indicates that ingestion of topical steroids may rarely trigger acute GPP.