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Lymphocyte kinetics in pustular psoriasis

D N Sauder, W D Steck, P B Bailin

    Journal of the American Academy of Dermatology
    |April 1, 1981
    PubMed
    Summary
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    Generalized pustular psoriasis involves sterile pustules and can be lethal. A new finding shows absolute lymphopenia, or low lymphocyte count, signals an impending pustular flare, allowing for timely treatment.

    Area of Science:

    • Dermatology
    • Immunology
    • Hematology

    Background:

    • Generalized pustular psoriasis (GPP) is a severe, potentially life-threatening variant of psoriasis vulgaris.
    • GPP is characterized by sterile pustules on inflamed skin, often accompanied by systemic symptoms.
    • The pathogenesis of GPP and its early warning signs require further elucidation.

    Purpose of the Study:

    • To identify early indicators of generalized pustular psoriasis flares.
    • To investigate the role of lymphocyte counts during pustular psoriasis exacerbations.
    • To describe a novel hematological finding termed 'lymphocyte eclipse' in GPP.

    Main Methods:

    • Observation and documentation of hematological parameters in patients presenting with pustular psoriasis.
    • Monitoring of white blood cell and absolute lymphocyte counts during pustular flares.

    Related Experiment Videos

  • Clinical correlation of lymphocyte counts with the onset and severity of pustular psoriasis activity.

    • Main Results:

    • An absolute lymphopenia (a significant drop in lymphocyte count) was observed at the onset of pustular psoriasis flares.
    • Concurrent with elevated white blood cell counts (25,000-40,000/µL), lymphocyte counts decreased from normal levels.
    • This 'lymphocyte eclipse' phenomenon was documented in ten patients with generalized pustular psoriasis.

    Conclusions:

    • Absolute lymphopenia, or 'lymphocyte eclipse,' is a reliable predictor of impending generalized pustular psoriasis activity.
    • Early identification of this hematological sign may allow for prompt therapeutic intervention.
    • Timely treatment initiation can potentially prevent severe, life-threatening complications associated with pustular psoriasis flares.