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Atypical forms include ‘erythrodermic’ and ‘pustular’ psoriasis

Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin. Erythrodermic psoriasis occurs when the rash becomes very widespread, and can develop from any of the other types. This may include pits in the nails or changes in nail color. Annular pustular psoriasis (APP), a rare form of generalized pustular psoriasis, is the most common type seen during childhood. Pustular psoriasis is an uncommon form of psoriasis consisting of widespread pustules on an erythematous background, as shown in the image below. Pustular psoriasis may result in erythroderma. These include the following:. Patients with a history of chronic psoriasis vulgaris prior to generalized pustular eruption tend to have a better prognosis than patients with more atypical forms of psoriasis. Pustular psoriasis can occur on any part of the body, but occurs most often on the hands or feet. Symptoms include pitting and discoloration of the nails, severe scalp scaling, diaper dermatitis or plaques similar to that of adult psoriasis on the trunk and extremities.

Atypical forms include 'erythrodermic' and 'pustular' psoriasis 2Psoriasis lesions typically are classified by their morphologic appearance and include plaque, guttate, pustular, and erythrodermic forms. Few review articles on psoriasis discuss the rare variant termed psoriasis rupioides. Other less common psoriasis forms include inverse psoriasis (involving the skin folds), erythrodermic (from chronic plaque psoriasis or acute), pustular and guttate (with ‘dewdrop’ lesions). When a patient with psoriasis presents with sepsis while on systemic therapy, always consider atypical infections. Predisposing factors include trauma, infections such as staphylococci, streptococci, HIV and candida species, medications, stresses, cigarette smoking and alcohol. Diagnosis of psoriasis is more difficult in children due to atypical characteristics and limited involvement of skin. Erythrodermic and pustular forms of psoriasis, on the other hand are considered unusual in children.

Psoriasis is a chronic inflammatory skin condition characterised by clearly defined, red and scaly plaques (thickened skin). Generalised pustulosis and localised palmoplantar pustulosis are no longer classified within the psoriasis spectrum. Validated tools used to evaluate psoriasis include:. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea. Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely. PPP causes large pustules to form at the base of the thumb or on the sides of the heel. Characterized by severe scaling, itching, and pain that affects most of the body, erythrodermic psoriasis disrupts the body’s chemical balance and can cause severe illness. Other medications used to treat severe psoriasis include etrentinate (Tegison) and isotretinoin (Accutane), whose chemical properties are similar to those of vitamin A.


The goal of treatment of generalized pustular psoriasis (GPP) includes improvement of skin manifestations, alleviation of associated systemic symptoms, and to minimize the risk of life-threatening systemic complications. HIV infection and its fulminant form AIDS are associated with immune deficiency, especially of the thymus-dependent system. As immunosuppression occurs, nonspecific skin changes occur in which common disorders have atypical features. They include hyperkeratotic papules, folliculitis, verrucous lesions, chronic ulcerations, disseminated ecthyma lesions and chronic varicella-zoster infection mimicking BCC. Are there different types of psoriasis? In addition it may be categorized into different types: plaque, pustular, erythrodermic, guttate or inverse psoriasis. Type-specific symptoms include: Plaque psoriasis (the most common type): raised, thickened patches of red skin covered with silvery-white scales;. Familial tendency to develop freckles or prominent or atypical (unusual-looking) moles. Other causative factors include drug reactions (20 percent), malignancies (11 percent), and idiopathic (17 percent). Erythrodermic psoriasis is a rare and severe form of psoriasis occurring in 1-2. The clinical findings in erythroderma caused by reactive arthritis may mimic the appearance of erythrodermic pustular psoriasis.

Psoriasis. Dermnet Nz