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Histopathological analysis confirmed SPD, and following intolerance to initial treatment with dapsone, the patient experienced a dramatic and sustained clinical improvement with infliximab. This case highlights the diagnostic challenges posed by atypical presentations of SPD and supports the use of tumour necrosis factor-alpha (TNF\u03b1) inhibitors as a highly effective treatment option.<\/jats:p>","DOI":"10.1136\/bcr-2025-266247","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T08:30:24Z","timestamp":1753950624000},"page":"e266247","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Subcorneal pustular dermatosis masquerading as eczematous dermatitis: a case report and mechanistic review"],"prefix":"10.1136","volume":"18","author":[{"given":"Peter","family":"Dimitrion","sequence":"first","affiliation":[{"name":"Dermatology, Henry Ford Health, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria L","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Dermatology, Henry Ford Health, Detroit, Michigan, 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