Generalized pustular psoriasis (GPP) is an extremely rare type of psoriasis that can present in a variety of forms. It also may or may not recur periodically. Most cases of generalized pustular psoriasis present in patients with existing or prior psoriasis conditions. A Case of Acute Generalized Pustular Psoriasis of von Zumbusch Triggered by Hypocalcemia. GPP may also present severe extracutaneous manifestations including pneumonitis, heart failure and hepatitis. The acute variant (also known as generalized pustular psoriasis of von Zumbusch) is characterized by sudden onset of the pustular eruption accompanied by systemic symptoms of fever and malaise. GPP may also present as a less acute disorder in which patients develop widespread annular or figurate erythematous plaques with peripheral pustules and scale (generalized annular pustular psoriasis) 4,5. Clinical profile, morbidity, and outcome of adult-onset generalized pustular psoriasis: analysis of 102 cases seen in a tertiary hospital in Johor, Malaysia.
Within a few hours, clusters of superficial, nonfollicular, 2 to 3-mm sized pustules may develop in a generalized distribution. It can occur at any age but the majority of cases first present before the age of 35 years. Infection:Streptococcal infection is strongly associated with the development of guttate psoriasis but this may also apply to chronic plaque psoriasis. Acute episodes of plaque psoriasis may evolve into more severe disease – eg, pustular or erythrodermic psoriasis. Any systemic upset, such as fever and malaise, which are common in unstable forms of psoriasis such as erythroderma or generalised pustular psoriasis. Psoriasis prevalence is also an important consideration for WHO. Scalp involvement might be accompanied by non-scarring alopecia (E).
Several clinical variants of pustular psoriasis exist: generalized pustular psoriasis (von Zumbusch type), annular pustular psoriasis, impetigo herpetiformis, and two variants of localized pustular psoriasis (1) pustulosis palmaris et plantaris and (2) acrodermatitis continua of Hallopeau. If pustules are present, the disorder is called pustular psoriasis. Impetigo herpetiformis, or pustular psoriasis of pregnancy, is a very rare skin disorder with few cases described in the medical literature. Generalized pustular psoriasis is also known as Von Zumbusch pustular psoriasis. That antibody is not present in the blood of patients with psoriatic arthritis. Please try again in a few minutes. We describe a patient with acute generalized pustular psoriasis (GPP) treated with the new anti interleukin (IL)-17A antibody, secukinumab, who showed a remarkable response with almost complete resolution of pustulation after the first injection.
Pustular Psoriasis Symptoms
Generalized pustular psoriasis may exacerbate by pregnancy, premenstrual, and by high dose of estrogen therapy. Children and teenagers often have the guttate type of psoriasis, while older patients may present with the other different clinical forms and the severe types of psoriasis such as erythrodermic and the pustular types. Psoriatic arthropathy: arthropathy is rare and occurs in chronic cases. Reports of carcinoma in the site of local coal tar treatment is few but may occur. On the other hand, patients with generalized pustular psoriasis (GPP) can exhibit pustular lesions on the palms and soles. In the majority of patients, bilateral palmar lesions antecede the plantar involvement with a few months duration. In the cases of acute onset, solitary pustules may also be seen on the trunk, however, severe cases mimicking pustular psoriasis are also seen. Those cases indicate clinical similarities of both diseases, and extra-palmoplantar lesions associated with PPP sometimes present with features resembling psoriasis. The skin around an affected nail is sometimes inflamed, and the nail may peel away from the nail bed. Generalized pustular psoriasis is also known as Von Zumbusch pustular psoriasis. Pustules appear within a few hours, then dry and peel within two days. Psoriasis may be divided into psoriasis vulgaris, generalized pustular psoriasis, and localized pustular psoriasis. In severe cases, the disease may affect the entire skin and present as generalized erythroderma. Others with palmoplantar, acral or generalized pustular psoriasis (GPP). MASS cases may also present with additional findings like leukemia cutis. Our study also supports the concept that AGEP is a separate entity that is distinct from GPP. Figure 3: Histopathology of acute generalized pustular psoriasis. AGEP and 24 biopsies of 19 cases with an established diagnosis of GPP.
Localized Acute Generalized Exanthematous Pustulosis with Amoxicillin and Clavulanic Acid Asl nur zkaya-Parlakay1, Dilek Azkur2, Ate Kara1, Y lmaz Y ld z2, Diclehan Orhan3, A. Some authors still discuss that AGEP and pustular psoriasis are related. 5); papillary dermal edema, parakeratosis, acanthosis, and papillomatosis may also be present. In case reports, positive effects on pustular variants of psoriasis have also been reported. Possibly, site-specific factors or a differential contribution of immunological processes modulated by TNF inhibitors to palmoplantar pustulosis and plaque-type psoriasis may have played a role. With 80 of the patients reaching at least a 75 reduction of their baseline skin symptoms after 10 weeks of therapy 14, infliximab is regarded as one of the most potent agents available at present for the treatment of psoriasis vulgaris. Its relationship with psoriasis is clear as the patient may have plaque-type psoriasis prior to 2 or after the onset of pustular psoriasis. Several drugs have also been reported to cause generalized pustular psoriasis. We present a case of acute generalized pustular psoriasis exacerbated by telmisartan, which is an antihypertensive of the angiotensin II receptor blocker category. A noticeable gradual regression of new lesions and healing of existing lesions was observed within few days of treatment.