Unusual Presentation of Pustular Psoriasis on the Face: A Case Report

This case report describes an unusual presentation of pustular psoriasis on the face in a 36-year-old woman with a history of systemic lupus erythematosus (SLE). The patient presented with a rapidly worsening facial rash initially diagnosed as pustular psoriasis with superimposed bacterial impetiginization. Following ineffective initial treatment, she was started on spesolimab, a newly Food and Drug Administration (FDA)-approved monoclonal antibody targeting IL-36R, which led to rapid clinical improvement. The report highlights the clinical challenges of diagnosing pustular psoriasis, particularly in atypical cases, and underscores the importance of early intervention with targeted therapies to prevent disease progression.