Pustular Psoriasis

Generalized pustular psoriasis is a rare form of psoriasis. It usually presents with systemic development of pustules all over the body. The condition is quite severe and most individuals are very sick. If not diagnosed and treated promptly, death is a frequent outcome. The pustules typically develop on an area surrounded by red and painful skin. Frequently the condition is also known as acute generalized pustular psoriasis of von Zumbusch.

Pustular psoriasis can also occur in a localized form. This is usually seen with the development of pustules only on the hands and feet.

In adults, the condition affects men and women equally. In children, it affects boys somewhat more often than girls. The average age of people with pustular psoriasis is 50 years. In rare cases, children aged 2-10 years can also be affected.

Causes generalized pustular psoriasis

The causes of generalized pustular psoriasis are unknown. Some individual may have had the plaque type of psoriasis in the past. Even though the cause remains unknown, there are several factors which can trigger the condition. These trigger factors include:

- abrupt cessation of corticosteroids use

- medications such as lithium, salicylates, indomethacin, iodides and some beta-blockers

- topical chemicals like coal tar and dithranol

- some Infections

- Pregnancy

- Sunlight or phototherapy

In many people, the trigger is never identified.

Signs and symptoms

In all cases, the rash is fiery red and is associated with pain. Most individuals also develop systemic features of a fever, chills, headache, loss of appetite, nausea and weakness. Soon after these features, pustules appear on the body. The pustules do tend to cluster around the genitals, elbow and knee creases. Within 24 hours, these pustules form pus collections and then fall off. Newer crops of pustules then form in the same area. Successive crops of pustules may appear and erupt every few days or weeks.

The sudden onset of this condition can be quite frightening. If the diagnosis is made early, survival is possible and the condition either reverts back to its original stage or into a generalized skin rash. Most individuals continue to develop recurrent episodes.

The localized form of pustular psoriasis of the palms and soles is usually chronic and may be associated with bone or joint inflammation. Unlike the generalized condition, this form of pustular psoriasis is not as serious.