Generalized pustular psoriasis induced by terbinafine

Background Generalized pustular psoriasis (GPP) is a rare and severe inflammatory disease characterized by widespread and superficial sterile pustules on an erythematous background. Objectives This multicentre study aimed to determine the clinical profile and course in a large cohort of patients with GPP. Methods One hundred and fifty‐six GPP patients (mean age, 44.2 ± 18.7 years) who met the diagnostic criteria of the European Consensus Report of GPP were included in the study. Sociodemographic characteristics, quality of life, triggering factors of the disease, clinical, laboratory, treatment and prognostic features were evaluated. Results 61.5% of the patients were female. The rate of working at or below the minimum wage (≤$332.5/month) was 44.9%. Drugs (36.5%) were the most common trigger. While hypocalcaemia (35.7%) was the most important cause of GPP during pregnancy, systemic steroid withdrawal (20%) was the most frequently reported trigger for infantile/juvenile and mixed‐type GPP (15%) (P < 0.05). Acute GPP (53.8%) was the most common clinic. Nails were affected in 43.6% of patients, and subungual yellow spots (28.2%) were the most common change. In annular GPP, fever (P < 0.001) and relapse frequency (P = 0.006) were lower than other subtypes, and the number of hospitalizations (P = 0.002) was lower than acute GPP. GPP appeared at a later age in those with a history of psoriasis (P = 0.045). DLQI score (P = 0.049) and joint involvement (P = 0.016) were also higher in this group. Infantile/juvenile GPP was observed in 16.02% of all patients, and arthritis was lower in this group (24.4 vs. 16%). GPP of pregnancy had the worst prognosis due to abortion observed in three patients. Conclusions Recent advances in treatment have improved mortality associated with GPP, but abortion remains a significant complication. Although TNF‐α inhibitors have proven efficacy in GPP, they can also trigger the disease. Mixed‐type GPP is more similar to acute GPP than annular GPP with systemic manifestations and course.

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“…Many triggering factors have been reported in the literature 11,25–29 . In our study, the most prominent group was drugs ( n = 57, 36.5%).…”

Section: Discussionmentioning

confidence: 46%

“…6 Many triggering factors have been reported in the literature. 11,[25][26][27][28][29] In our study, the most prominent group was drugs (n = 57, 36.5%). In line with the existing literature studies, 5,23 antibiotics (9.61%) and systemic steroid withdrawal (7.69%) were the most common triggers.…”

Section: Discussionmentioning

confidence: 50%

Sociodemographic, clinical, laboratory, treatment and prognostic characteristics of 156 generalized pustular psoriasis patients in Turkey: a multicentre case series

Polat

Alpsoy

Kalkan

et al. 2022

Acad Dermatol Venereol

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“…Fourteen studies assessing comorbidities of GPP were conducted in countries outside of Europe and Japan, including China, USA, Malaysia and Tunisia (Table 5) . 6,8,12,25,48,51,53,54,66,69,70,72,73,87 Three studies were conducted in patients with juvenile GPP, which may have affected comorbidity rates 51,53,70 as conditions such as hyperlipidaemia and type 2 diabetes are less prevalent in children.…”

Section: Comorbidities Of Gpp In Countries Outside Europe or Japanmentioning

confidence: 99%

Section: Gpp Relapse Rates and Number Of Flaresmentioning

confidence: 99%

“…The relapse rate in patients with GPP varies considerably, from 32.3% to 61.4% (Table 1), 8,25,28,44,[47][48][49][50][51][52][53][54] even when discounting a study of three patients that showed a relapse rate of 100%. 53 This can potentially be attributed to different patient population characteristics and reported GPP variants across these studies. There was also a considerable disparity in relapse definition, which included hospital readmission, resistance to treatment or relapse due to cessation of treatment or infection (Table 1).…”

Section: Gpp Relapse Rates and Number Of Flaresmentioning

confidence: 99%

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Prevalence, comorbidities and mortality of generalized pustular psoriasis: A literature review

Prinz

Choon

Griffiths

et al. 2022

Acad Dermatol Venereol

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Generalized pustular psoriasis (GPP) is a rare auto‐inflammatory skin disease characterised by acute episodes of sterile pustule formation. Diagnosis and treatment of the disease have historically been complicated by a lack of awareness, and no consistent global definition or clinical coding standards. Now acknowledged as a distinct clinical entity with a recognised genetic component, GPP can take a serious and life‐threatening course due to systemic inflammatory complications and its association with various comorbidities. As with other rare diseases, there are significant challenges to understanding the epidemiology of GPP, notably a small patient population, non‐standardised study methodologies and ethnic differences in its presentation. A clearer understanding of GPP is therefore required for clinicians to better manage patients with this rare condition. In this review article, we present an overview of the available data on GPP prevalence estimates in key demographics and report the frequency of genetic mutations associated with the disease. We detail the incidence of known comorbidities and summarise the data on mortality and assigned causes of death. Lastly, we discuss the various factors that impact the collection, interpretation and comparison of these data.

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Neutrophile Dermatosen: ein manchmal unterschätztes Erkrankungsspektrum

Drach

2022

hautnah

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Generalized pustular psoriasis induced by terbinafine

Cited by 7 publications

References 3 publications

Sociodemographic, clinical, laboratory, treatment and prognostic characteristics of 156 generalized pustular psoriasis patients in Turkey: a multicentre case series

Sociodemographic, clinical, laboratory, treatment and prognostic characteristics of 156 generalized pustular psoriasis patients in Turkey: a multicentre case series

Prevalence, comorbidities and mortality of generalized pustular psoriasis: A literature review

Neutrophile Dermatosen: ein manchmal unterschätztes Erkrankungsspektrum

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