Pustular Psoriasis: What Makes It Unique?

The abrupt discontinuation of corticosteroid-based treatments in patients with plaque psoriasis is often the first cause identified as a trigger for pustular psoriasis. Generally, the products used for these treatments are gradually discontinued when they are prescribed for more than 5 days.

Pustular Psoriasis is not caused by poor skin hygiene or bacteria. It originates from a genetic factor associated with an overactive immune system.

One of the suspected causes of the frequent onset of this pathology is the administration of certain medications such as aspirin derivatives and lithium or the initiation of certain drugs like ustekinumab.Tobacco use and stress are not triggering factors for this disease, but they can exacerbate its flare-ups.

Complications related to this disease can occur for a variety of reasons, including secondary bacterial infection, hypoalbuminemia, hypocalcemia, renal tubular necrosis, or malnutrition. Furthermore, untreated patients have an increased risk of cardiorespiratory failure. Mortality data from studies on patients with GPP are limited, but rates of 3% and 7% have been reported.

Immediate intervention is necessary in the case of palmoplantar pustulosis psoriasis due to the pain it can cause. The treatment is based on topical corticosteroids such as ointments, creams, or lotions. If this option proves ineffective, doctors turn to phototherapy or drug treatments using Methotrexate, Cyclosporine, or Acitretin.

For cases of pustular psoriasis on the nails, the treatment involves injections of corticosteroids under the nails. This treatment inflicts intense pain on the patients, which compels doctors to suggest phototherapy or the use of nail polish based on urea instead.

Complications are not uncommon with generalized pustular psoriasis. It is advised to consult a doctor as soon as symptoms appear. Treatment may include the prescription of retinoid-derived medications or phototherapy sessions.