- Signs & Symptoms
- Causes & Risk Factors
Generalized pustular psoriasis (GPP) is a rare, severe type of psoriasis that covers large areas of the body and characterized by pus-filled blisters rather than plaques.
GPP can occur along with psoriasis vulgaris, in which typical plaque-type lesions may be seen on the skin. GPP can be extremely dangerous and even fatal. Because it usually requires hospitalization and immediate treatment.
In some people, the condition will go away within a few days or weeks. Despite this, the illness is known to recur.
What are signs and symptoms of generalized pustular psoriasis?
Pustules that appear in a wave-like fashion on psoriatic or normal skin are the most common sign of generalized pustular psoriasis. These pinhead-sized, sterile pustules are often found at the borders of growing, severely inflammatory plaques or over inflamed skin. The type and severity of GPP signs and symptoms vary among afflicted individuals.
Common signs and symptoms of GPP include:
- Reddish discoloration of the skin
- Pus-filled blisters (pustules) over the body
- Fever and chills
- Rapid heartbeat
- Nausea and loss of appetite
- Muscle weakness
- Furrowed tongue
- Nail abnormalities
Initially, red and painful areas of skin may be seen. Within a few hours, 1- to 2-mm pustules appear. After a day or so, the pustules consolidate to create blisters that dry up and peel away, leaving a glazed, smooth appearance to the skin.
What are causes and risk factors for generalized pustular psoriasis?
In many cases, the exact cause of generalized pustular psoriasis is unknown. GPP often occurs in people who already have psoriasis. However, many cases of GPP occur even without a history of psoriasis.
Common causes of GPP include:
- Genetic mutations:
- Mutations in the IL-36RN gene
- Mutations in the CARD14 gene
- Mutations in AP1S3 genes
- Use or withdrawal of certain drugs:
- Psoriasis medications
- Some beta-blockers
- Iodide-containing medicines
- Nonsteroidal anti-inflammatory drugs, such as indomethacin
- Dental infections
- Upper respiratory tract infections
Risk factors for GPP include:
- History of or existing psoriasis
- Irritation from topical coal tar and anthralin therapy
- Age (GPP can present at any age but is rarer in young children)
Research on dermatology has proposed a classification for two conditions that include:
- Represents patients with a personal history of psoriasis
- The most common precipitating factor is corticosteroid withdrawal
- Represents patients with no history of psoriasis
- The most common precipitating factor is infection
A triggering factor causes the illness in the vast majority of cases.
What are treatment options for generalized pustular psoriasis?
Treatment for generalized pustular psoriasis varies widely, and several different medications have been shown to be effective. The goal of treatment is to:
- Reduce fluid loss
- Restore electrolyte balance
- Limit secondary infections.
GPP may even require hospitalization in severe cases or when there are systemic complications such as electrolyte imbalances.
Treatment options for GPP include:
- Application of low-potency corticosteroids
- Immunosuppressant drugs
- Oral retinoid medications
- Tumor necrosis factor blockers
- Interleukin or interleukin receptor antagonists
- Chemotherapeutic agents
- Phototherapy, which uses ultraviolet B light to treat affected areas of skin
- Regular medical screening
Treatment methods are determined by the extent of body surface area affected:
- Topical therapy with steroid creams or ointments are usually sufficient for limited skin involvement.
- Systemic treatment, which can include either oral medicine or injectable biologic therapies, is usually necessary for more extensive illness.
- Treatment of more severe GPP may involve electrolyte monitoring, which is why hospitalization is required.
- Many of the most effective GPP therapies are fast-acting, such as cyclosporine or infliximab.
- Interestingly, some patients with GPP have a mutation in a protein called interleukin-36; future treatments for these individuals may include more focused medications targeting interleukin-36-related biological pathways.
- Experts advise individuals with GPP to contact a dermatologist as soon as possible. A multi-pronged strategy is often required to restore quality of life.
- Attachment Theory: What It Is, Stages & the Different Attachment Styles
- Gentle Parenting: What It Is, Techniques & Discipline
- U.S. Nursing Homes Fail to Report Many Serious Falls, Bedsores: Study
- The Younger You Get Diabetes, the Higher Your Risk for Dementia Later
- FDA Grants Full Approval to Paxlovid to Treat COVID-19
- More Health News »
Can generalized pustular psoriasis be prevented?
If a person already has psoriasis and develops early signs and symptoms of GPP, receiving quick medical assistance may help stop the illness from progressing.
Similarly, patients who are taking medications that have the potential to cause GPP may benefit from learning how to detect triggers so that they can detect the signs as soon as possible.
Proper nutrition, fluid intake, and timely treatment of infections with antibiotics is recommended.
What are possible complications of generalized pustular psoriasis?
Complications of GPP may include:
- Electrolyte imbalance
- Malabsorption of nutrients and drugs
- Kidney and liver malfunction
- Secondary bacterial infections
- Erythroderma (reddening of skin) following remission
In addition to general care of complications, specific therapy may include systemic steroids, methotrexate, oral retinoids, or cyclosporin-A.
What is the prognosis for generalized pustular psoriasis?
Severity of symptoms and any related problems determine the prognosis of GPP. Remission occurs in most cases within a few days or weeks. However, the disease may recur.
GPP can be fatal, and hospitalization is usually required to save the patient.
Health Solutions From Our Sponsors
Generalized pustular psoriasis: https://dermnetnz.org/topics/generalised-pustular-psoriasis
Generalized Pustular Psoriasis: https://www.ncbi.nlm.nih.gov/books/NBK493189/
Generalized Pustular Psoriasis: https://www.psoriasis.org/generalized-pustular-psoriasis/
Generalized Pustular Psoriasis: https://rarediseases.org/gard-rare-disease/generalized-pustular-psoriasis/
Top What Is Generalized Pustular Psoriasis Related Articles
Biologics (Biologic Drug Class)A biologic drug is a product that is produced from living organisms or contain components of living organisms. Biologics include recombinant proteins, tissues, genes, allergens, cells, blood components, blood, and vaccines. Biologics are used to treat numerous disease and conditions, for example, anemia, chronic migraine, hepatitis B, hemophilia, respiratory syncytial virus (RSV) prophylaxis, HPV prevention, rheumatoid arthritis, inflammatory bowel disease.
Can Psoriasis Go Away?Psoriasis is a skin disease that develops due to changes in genetic makeup, and most often, it is passed from your parents (hereditary). It may also occur due to changes in the immune system, autoimmune response, in which your own antibodies start attacking the cells of your body. Psoriasis is a chronic inflammatory condition that has no definite cure and only the symptoms can be managed.
clobetasolClobetasol is a synthetic topical corticosteroid used as cream, gel, spray, lotion, ointment, and shampoo for temporary relief from symptoms of plaque psoriasis and other inflammatory skin conditions. Prolonged use in children can affect their growth and development. Common side effects of clobetasol include hypothalamic-pituitary-adrenal (HPA) axis suppression, application site reactions (irritation, discomfort, burning), skin reactions, upper respiratory tract infection, inflammation of nose and throat (nasopharyngitis), Streptococcal pharyngitis, headache, and numbness of fingers.
coal tar topicalCoal tar topical is a medication applied on the skin and scalp for the relief of symptoms including itching, scaling, flaking, redness, and irritation caused by skin conditions such as dandruff, seborrheic dermatitis, eczema and psoriasis. Common side effects of coal tar topical include dermatitis, skin irritation, stinging and burning, skin peeling (desquamation), inflammation of the hair follicles (folliculitis), acne-like eruptions, skin photosensitivity, staining, and discoloration.
CorticosteroidsOral and injectable systemic corticosteroids are steroid hormones prescribed to decrease inflammation in diseases and conditions such as arthritis (rheumatoid arthritis, for example), ulcerative colitis, Crohn's disease, asthma, bronchitis, some skin rashes, and allergic or inflammatory conditions that involve the nose and eyes. Examples of systemic corticosteroids include hydrocortisone (Cortef), cortisone, prednisone (Prednisone Intensol), prednisolone (Orapred, Prelone), and methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol). Some of the side effects of systemic corticosteroids are swelling of the legs, hypertension, headache, easy bruising, facial hair growth, diabetes, cataracts, and puffiness of the face.
gotu kolaGotu kola is a medicinal herb (Centella asiatica) that has been used in traditional Chinese and Indian Ayurvedic medicine systems to treat circulatory conditions, wound healing, abdominal disorders, and memory enhancement. Gotu kola is used for treating wounds, thick raised scarring (hypertrophic scarring), psoriasis, venous insufficiency, varicose veins, Alzheimer’s disease, Parkinson’s disease, anxiety, depression, insomnia, and others. Common side effects of gotu kola include nausea, gastrointestinal upset, high cholesterol levels, burning, skin rash, itching (pruritus), photosensitivity, allergic contact dermatitis, drowsiness, dizziness, and others.
How to Get Rid of Psoriasis QuicklyAlthough psoriasis is incurable, it responds to topical and systemic treatments. Topical treatments that may be effective to treat mild psoriasis include creams, lotions, and sprays.
Prednisone is a drug that belongs to the corticosteroid drug class, and is an anti-inflammatory and immune system suppressant. It's used to treat a variety of diseases and conditions, for example: inflammatory bowel disease (Crohn's disease and ulcerative colitis), lupus, asthma, cancers, and several types of arthritis.
Common side effects are weight gain, headache, fluid retention, and muscle weakness. Other effects and adverse events include glaucoma, cataracts, obesity, facial hair growth, moon face, and growth retardation in children. This medicine also causes psychiatric problems, for example: depression, insomnia, mood swings, personality changes, and psychotic behavior. Serious side effects include reactions to diabetes drugs, infections, and necrosis of the hips and joints.
PsoriasisPsoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales. There are several types of psoriasis, including psoriasis vulgaris, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Symptoms vary depending on the type of psoriasis the patient has. Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy. There is no cure for psoriasis.
Psoriasis Picture 1A reddish, scaly rash often located over the surfaces of the elbows, knees, scalp, and around or in the ears, navel, genitals or buttocks. See a picture of Psoriasis and learn more about the health topic.
Severe Psoriasis PicturesExplore the different types of psoriasis such as plaque psoriasis, inverse psoriasis, and scalp psoriasis. Discover what causes psoriasis and many psoriasis treatment options.
Psoriasis Home RemediesDiscover home remedies for psoriasis and help heal irritated skin.
Psoriasis SlideshowWhat is psoriasis? See examples of psoriasis including the different types of nail, plaque, and scalp psoriasis. Learn about psoriasis symptoms, causes and treatment.
Plaque Psoriasis: Top 10 Causes, Triggers and TreatmentsPlaque psoriasis triggers a red, scaly rash of plaques on the skin typically affecting the elbows, knees, and scalp. Treatment involves managing triggers and controlling symptoms by addressing causes such as stress, allergies, infections, hormones, and more.
salicylic acid topicalSalicylic acid topical is a medication used to soften and remove warts, calluses, and corns in the foot and in the treatment of skin conditions such as acne, psoriasis, and seborrheic dermatitis. Avoid prolonged use or application on large areas of the skin. Common side effects of salicylic acid topical include irritation, burning, stinging, scaling, peeling and shedding, confusion, dizziness, headache, rapid and deep breathing (hyperventilation), and ringing in the ears (tinnitus). Consult your doctor if pregnant or breastfeeding.
What Is the Best Treatment for Psoriasis?
Psoriasis is an incurable chronic autoimmune disorder of the skin that causes patches of thick, flaky, scaly skin, mostly around the scalp, knees, and elbows, though any skin surface may be involved. Some people experience only small patches while others have red, inflamed skin and think scaly patches all over the body. The exact cause of psoriasis is not clear, but it isn’t contagious.
What Are the Levels of Psoriasis? 5 TypesLearn the three levels of psoriasis, as well as the five different types, which each include their own symptoms, causes, triggers, treatment, duration, and prevention.
What Is the Main Cause of Psoriasis?Psoriasis is a non-contagious skin disease in which the skin cells grow in numbers faster than normal, producing rashes on the body. Normally, the cells on the surface of the skin are shed as new cells grow beneath. In psoriasis, the swift build-up of skin cells collects on the surface of the skin as scales or plaques. The exact cause of psoriasis is not completely understood. It appears to involve an interplay between a person’s genes, immune system and environment.
What Is Von Zumbusch Disease?Von Zumbusch disease or acute generalized pustular psoriasis is a rare and life-threatening type of psoriasis characterized by pus-filled pustules.
ZoryveZoryve is a topical prescription cream used to treat the symptoms of plaque psoriasis in adults and children over the age of 12. Zoryve is contraindicated in people with moderate to severe liver impairment (Child-Pugh B or C). Serious side effects of Zoryve that require immediate medication attention include hives, difficulty breathing, swelling of your face, lips, tongue, or throat; dizziness, mood or behavior changes, anxiety, depression, trouble sleeping, impulsive thoughts, thoughts of self-harm, rapid and unintended weight loss, pain or burning when you urinate, and tremors. Consult your doctor if pregnant or breastfeeding