LAUSR

Amicrobial pustulosis of the folds (APF) is a rare entity, characterized by outbreaks of sterile, eczematous, papulo-pustular lesions with a sudden onset and recurrent course, which frequently suffers from staphylococcal superinfection. It predominantly affects skin folds, external auditory canal, scalp and genital area1 . First described in 1991 by Crickx et al, and classically associated with autoimmune disorders such as systemic lupus erythematosus (SLE), it is currently included in the spectrum of non-infectious neutrophilic dermatoses. It has also been described in patients with inflammatory bowel disease (IBD), 2,3 which may also present pustular diseases and pyoderma gangrenosum. The use of TNF-alpha inhibitors has been associated with the appearance of cutaneous side effects such as paradoxical psoriasiform reactions, some of them as pustulosis4 . We present seven new cases of patients with Crohn's disease who developed lesions clinically compatible with amicrobial pustulosis of the flexures during their treatment with anti-TNF.