Generalized pustular psoriasis. A review of 63 cases

Area of Science:

• Dermatology
• Clinical Medicine

Background:

• A 29-year retrospective study analyzed 63 hospitalized patients with generalized pustular psoriasis (GPP).
• Patients were categorized into four subgroups: acute (von Zumbusch), subacute annular, chronic (acral), and mixed, based on disease onset and morphology.
• This classification aims to enhance understanding of GPP's diverse presentations.

Purpose of the Study:

• To classify generalized pustular psoriasis (GPP) patients into distinct subgroups.
• To improve the understanding of GPP variability.
• To aid in selecting appropriate treatment strategies for different GPP presentations.

Main Methods:

• Retrospective analysis of 63 hospitalized patients diagnosed with generalized pustular psoriasis (GPP) over 29 years.
• Classification of patients into four subgroups: acute (von Zumbusch), subacute annular, chronic (acral), and mixed.
• Analysis of patient demographics, disease characteristics, precipitating factors, complications, and hospitalization duration.

Main Results:

• The average age of onset for GPP was 50 years, with equal male and female distribution.
• Localized infections precipitated flares in 11 patients; approximately 25% experienced complications, primarily superinfections.
• Average hospitalization was 30 days, with hypocalcemia, female sex, and prior psoriasis history correlating with longer stays.

Conclusions:

• Topical therapies showed some benefit, but systemic medications were frequently required for GPP management.
• Coal tar, ultraviolet light (UVL), and psoralen-ultraviolet A (PUVA) may be effective treatments.
• Caution is advised with UVL and PUVA therapies as they can potentially exacerbate GPP.