Pustular Psoriasis: A Practical Review of the Literature

Abstract

Psoriasis is a chronic inflammatory skin condition linked to a dysregulation of the immune system that results clinically in well-circumscribed erythematous plaques with a silvery scale. In certain instances, the disease may manifest as a localized or generalized pustular variant that runs a more severe course and requires more diligent treatments. Precipitating factors influencing both the local and generalized forms include various drugs or withdrawal of certain drugs, irritation from topical therapy, infection, pregnancy, and sunburn. Many treatments for the pustular variant of psoriasis have been described in the literature, but no consensus statements have been published regarding the correct hierarchy of therapies to follow. Localized forms may be treated with topical or light therapies but may require systemic medications. Generalized forms most inevitably require aggressive systemic therapies offering a quick therapeutic response because of their increased morbidity and mortality. In all cases, the factors that are precipitating the disease must be eliminated. We present a review of the literature on the available treatments for pustular psoriasis.