Generalized pustular psoriasis: a review and update on treatment

Abstract

Generalized pustular psoriasis (GPP) is a subtype of pustular psoriasis characterized by painful and occasionally disfiguring cutaneous manifestations with sepsis-like systemic symptoms. Affecting any age and race, GPP can occur with other forms of psoriasis or by itself. Stimuli for flares include medications, infections and environmental triggers. The interleukin family and caspase recruitment domain family have been implicated in its pathogenesis. Other forms of pustular psoriasis include impetigo herpetiformis, palmoplantar pustular psoriasis, annular pustular psoriasis and acrodermatitis continua of Hallopeau. Treatment is not well established, but includes the use of retinoids, methotrexate, cyclosporine, corticosteroids, TNF-alpha inhibitors, topical therapy and phototherapy. The use of TNF-alpha inhibitors may result in the formation of antidrug antibodies and should be administered with methotrexate.

Pharmacokinetics of Risankizumab in Asian Healthy Subjects and Patients With Moderate to Severe Plaque Psoriasis, Generalized Pustular Psoriasis, and Erythrodermic Psoriasis

“…Generalized pustular psoriasis (GPP) is a rare and severe form of psoriasis that presents with flares of widespread sterile pustules on a background of red and tender skin and in rare cases can be fatal. About 10% of subjects with GPP have a preceding history of psoriasis . Erythrodermic psoriasis (EP) is another rare and severe variant of psoriasis that is difficult to treat and can be fatal.…”

“…About 10% of subjects with GPP have a preceding history of psoriasis. 2 Erythrodermic psoriasis (EP) is another rare and severe variant of psoriasis that is difficult to treat and can be fatal. It has an estimated prevalence among psoriatic patients ranging from 1% to 2.25%.…”

Two cases of acrodermatitis continua suppurativa (Hallopeau's disease) treated with IL‐17A inhibitors

“…Ein gutes therapeutisches Ansprechen wurde für TNF-Blocker [7], Anakinra und Ustekinumab [8] beschrieben. Sowohl Ixekizumab als auch Secukinumab sind für die Therapie der Plaque-Psoriasis und der Psoriasis-Arthritis zugelassen und haben auch eine Wirksamkeit bei der Psoriasis pustulosa generalisata gezeigt [9]. Wir berichten hier über die ersten beiden ACS-Patienten, die nicht ausreichend auf IL-17-Hemmer angesprochen haben…”

Tumor necrosis factor –238A is associated with pediatric‐onset generalized pustular psoriasis in Han patients in Eastern China

“…Generalized pustular psoriasis (GPP) is a severe variant of psoriasis, characterized by sudden fever and eruptions of erythema and pustules over large areas of the skin with significant mortality . The pathogenesis of GPP remains unclear.…”