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What is Pustular psoriasis? Pustular psoriasis or sometimes referred to as generalised pustular psoriasis is a type of psoriasis that is characterized by skin lesions or blisters filled with pus. The lesions sometimes occur in clusters and could be very painful. The pus is non-contagious and it’s not an infection at all. The skin around the pustules turns red and tender.
The condition is often rear and affects all races, men and women of older age equally with no exceptions. But with children, it affects them between the ages of 2 and 10 years old and tends to show up on boys more than girls
Often times when people ask what is pustular psoriasis? They also want to know how it plays out with other types of psoriasis. We will also be looking at the psoriasis cure as it relates to pustular psoriasis.
Sometimes pustular psoriasis can co-exist with plaque psoriasis or one following after the other but both are very different. The main difference between the two are the white pustules found in pustular psoriasis, these are absent on plaque psoriasis.
Here are some more distinguishing features of pustular psoriasis-
-The skin in and around the pustules is usually red
– It affects mostly the arm, the elbows and the knees, it rarely affects the face
– The pustules may also occur under the nails and as well as on the tongue.
– Apart from the hands, legs and knees, it can also spread very rapidly all over the body.
– The pustules and blisters will eventually turn brown and crusty and peel off later exposing shiny and scally skin.
– The circles of appearing, fusing and peeling off and reappearing again might last for weeks, making the patient uncomfortable and exhausted.
-The ring shaped type of pustular psoriasis is much more common in children than adults with less severe symptoms than in the generalised type of pustular psoriasis.
In the ring shaped plaque psoriasis, the plaques are elevated when they show up. You will find pustules all around the edges of the ring. The edges normally expand and the centre heals.
-In children, pustular psoriasis is often times are mild and you might see other symptoms of psoriasis beside the normal pustular psoriasis symptoms.
-For the palms and soles of the feet, pustular psoriasis in these areas is usually chronic and maybe associated with bone or joint inflammation leading to psoriatic arthritis. Usually when the pustules appear on these areas, they are white and yellow as they fill up with pus.
What causes pustular psoriasis is quite similar to the causes of plaque psoriasis. Though generally, all forms of psoriasis is triggered by a combination of genetic and environmental factors. But below are some factors known to be associated with pustular psoriasis and most are what triggers pustular psoriasis:
1- The use of strong and irritating topical solutions such as creams and soaps containing tar,
anthralin, steroids, and zinc pyrithione in shampoo.
2- Too much exposure to sunlight and phototherapy
3- Suddenly stopping the use of systemic steroids.
4- Taking other medications such as:-
-Salicylates, and compounds made from salicylic acids that are mostly used to treat patients with pain.
-Vitamin D derivatives and Calcipotriol
-Penicillin and some kinds of antibiotics
-Lithium or trazodone, and taking antidepressants
6- Having an unusually low level of calcium in the blood stream; a condition known as Hypocalcemia.
Having dealt with what is pustular psoriasis? There are different types of pustular psoriasis and accompanying psoriasis cure but first the different types include:
Palmer-Plantar Pustulosis (PPP)
This is sometimes called palmoplantar psoriasis. This is usually a localised form of pustular psoriasis that acts on the palms of the hands hence the name. But they are also found on the soles of the feet. This type of pustular psoriasis is more common with people between the ages of 20 and 60 years old and a lot more in people that smoke.
In PPP, when the pustules do show up, they are very large and about 5mm in diameter on the hands and feet such as the thumbs and the sides of the heels. Gradually, the pustules dry up, turn brown and then gradually fade away or peel off. This type is usually cyclical, when they old fade; new ones come up to replace them. Sometimes the skin do crack open in these areas and they are very painful leading to some form of loss of functionality especially in the hands.
Acrodermatitis Continua Of Hallopeau
This is also referred to as Acropustulosis. This form of pustular psoriasis is usually rear than the rest. Like PPP, it appears on the hands, the heels and the toes as well. Here, when the pustules burst, it exposes bright red patches that sometimes ooze.
This type can cause deformity in the toenails and bones of the fingers if left untreated. They are normally triggered by skin injury and sometimes by infections.
Von Zumbuschi Pustular Psoriasis
This is also called generalised pustular psoriasis. This form of pustular psoriasis normally begins with pains on the areas that are affected and those areas turn red. Within a matter of hours, pustules are formed and they dry up within a day or two.
The areas affected are very itchy and the patient may experience fever, chills, and dehydration. This is usually treated as an emergency since it could be life threatening.
Like most other types of psoriasis, this particular type of pustular psoriasis also comes and goes in circles. It most times can lead to weight loss, and its potential complications include, hair loss, nails loss, secondary bacterial infection and as well as liver damage. This type of pustular psoriasis is rear in children.
Pustular psoriasis treatment is very crucial and urgent when it comes to psoriasis cure and most especially pustular psoriasis because this is one form of psoriasis that could be life threatening. In situations like these, patients are normally hospitalised and kept under strict observation.
This is to prevent more dehydration, stabilize body temperature and the restoration of electrolyte imbalance. Most times doctors need to rotate treatments to avoid further complications especially with the stronger medications.
Studies have shown that the combination of of acitretin (brand name Soriatane) and methotrexate is usually very effective in checking pustular psoriasis. Below are the treatments for specific types of pustular psoriasis-
-Generalised Pustular Psoriasis treatment
All forms of pustular psoriasis require immediate medical attention and generalised pustular psoriasis is no exception. The doctors will have to rehydrate the body system after substantial loss of fluids, the patient will need to have his or her temperature stabilised.
Systemic medications for generalised pustular psoriasis include:
-Antibiotics for infections
-Biologic agents like infliximab, etanercept etec
This is one form of pustular psoriasis that has been hard to treat. But a good combination of topical preparations may help. For others, systemic medications may be all they need to get relief.
-Palmoplantar pustular psoriasis treatment
Here doctors find it easier to first use topical treatments before considering other options that are stronger treatments. The other options may include; including PUVA, UVB, acitretin, methotrexate or cyclosporine.
-Pustular Psoriasis Therapies
Apart from the various psoriasis treatments mentioned above, there is still other alternative pustular psoriasis therapies and remedies available. Mostly these are home cure for psoriasis that you can apply at home Some of these psoriasis home remedies may include:
– Diet changes,
-Stress-reducing techniques to help reduce symptoms.
Aside from the fact that psoriasis is a genetically motivated illness which of course means that there is little you can to prevent it; but you can also help by making sure that you stay away from those things that can trigger a flare up for you. And some of these can be applied to general psoriasis treatment are:
-Avoid any environmental factors like too much sun exposure, smoking and too much alcohol intake. These will serve to help you have a stronger immune that will have a better chance at fighting the condition.
-There are really no specific dietary restrictions but generally eating good food and staying as healthy as you should; will save you a lot of pain and heart ache.
When the condition does flare up:
-Seek immediate admission to the hospital
-There should be intensive nursing and care, paying attention to the level of body fluids, and temperature regulation.
-Endeavour to use bland or topical compresses and saline or oatmeal baths. These will help soothe the affected areas and give you some relief.
-Secondary bacterial infection of the skin
-Poor circulation and general toxicity may lead to liver failure.
-Malabsorption and malnutrition may occur
Table Of Contents
Just like anything in life, knowledge about problems or issues that you might have about anything; makes a great difference. The same goes for psoriasis. It is a sickness that can have major impact on the lives of patients.
So living with psoriasis can be a daunting task for most people but just a minor irritation for some. This is one illness that affects about 7million people in the United States alone and costs about 11.25 billion dollars annually in treatments.
So whichever way you look at it, knowing a bit more about psoriasis will go a long way to help you and your doctor make better decisions on the best psoriasis treatment that’s suits you. Most people actually have only one form of the disease but then after the symptoms are gone, they might experience another psoriasis trigger. Learning the different types of psoriasis will also help to know what causes psoriasis or what in effect triggers psoriasis?
So here are ways by which you can spot the 7 different types of psoriasis and the different signs and symptoms associated with each one of them.
This is the most prevalent form of psoriasis and it’s been estimated that 6 out 8 people that are afflicted with the condition has this form of psoriasis. It is characterised by red skin patches which are inflamed and are covered with silvery what scales. In some people, these patches do itch and burn at the same time. Then after a while, they may crack to become open sores and bleed.
The normally appear in the following areas-
This is a type of psoriasis that seems to cover the whole body surface leaving the whole surface looking burned and red. It is very rear and may occur just once or twice throughout the life time of psoriasis sufferers.
It most often brought about by unstable plaque psoriasis in which the lesions seem to just be all over the place.
This type of psoriasis is:
It has been noted by specialists that this kind of psoriasis could lead to serious complications as a direct result of low protein in the body and loss of fluid. Patients have also been known to experience infections, acute pneumonia and or congestive heart failure.
Erythrodermic Psoriasis triggers includes:
This is a type of psoriasis that is commonly found in children. It is the 2nd most common type of psoriasis right behind plaque psoriasis. They usually show as small reddish sports on the skin. This kind of psoriasis may disappear within a matter of weeks even without being treated. How to cure guttate psoriasis is not that difficult but first, you need to know the symptoms
The parts of the body that are most affected are
– The trunk
-Upper arms and
Guttate psoriasis triggers
The things that trigger guttate psoriasis
This could include-
Pustular psoriasis as the name implies shows up as white pustules or blisters. The pustules normally contain pus made up of white blood cells but are not infectious and also not contagious. The areas around the pustules are always surrounded by red skin.
It normally attacks much more older people and can be a direct result of the following-
-Increased heat rate
Pustular psoriasis triggers include:
-Exposure to some kinds of chemicals found in everyday products or at the work environment.
-The over use of strong topical steroids over a substantial area of the body
-If you suddenly stop any systemic treatments prescribed by your doctor
-Exposure to too much sunlight (Ultraviolet rays) with some form of sun screen protection.
-Certain kinds of stressful situations in your life and
Sometimes called intertriginous psoriasis normally appears in the folds of the skin. They are red lesions and could be smooth and shiny in some patients; sometimes the sufferers will also have other kinds of psoriasis on other parts of their body at the same time. This kind of psoriasis doesn’t produce scales, the locations on which they show up are-
-The skin folds of the genitals
-The skin folds around the buttocks
-For women, the area under the breasts
-The groin as well
This kind of psoriasis afflicts about 23% of all psoriatic patients. You will recognise it by the painful swelling in and around the joints of the body.
In fact it’s a combination of arthritis and psoriasis at the same time. It sometimes causes scally patches of the skin around those joint areas. Close to 90% of psoriatic arthritis sufferers also have nail changes too.
This type usually affects most adults, usually people who are between 30 to 50 years old. In this case, it’s usually very important to be diagnosed early to prevent deformity due to joint and tissue damage.
The common symptoms of psoriatic arthritis include:
-Discoloured warm joints
-Swelling of the fingers and the toes
This are changes to the nails of the fingers and the toes which are normally brought on by some other diseases.
Half of the folks with active psoriasis have this form of psoriasis due to severe pain especially those with psoriatic arthritis. Most times those with this form psoriasis will need to stop certain activities and worse even when combined with psoriatic arthritis. To treat nail psoriasis, one should know its symptoms.
Common symptoms of nail psoriasis include:
-The total crumbling and eventual loss of the entire nail due to weakening of the nail matrix by psoriasis.
-Pitting of the nails due to loss of parakeratotic cells from surface of nail plate.
-The nails will sometimes become tender and very painful
-The nails might turn yellowish-brown.
It’s been noted by doctors that Pustular Psoriasis is a rear form of psoriasis that afflicts the skin. They account for less than 10% of all psoriasis occurrences. They afflict both male and female of older ages in all races but less common in children. The average age of adults that have pustular psoriasis is 50years.
Pustular Psoriasis; show up as raised bumps which are filled with white thick fluid or pus. Pus normally is an indication of infection, but there is no medical evidence that show that infection plays any role at all in pustular psoriasis.
The whole areas around the skin usually appear red and the changes are similar to those seen in people with regular psoriasis-which are patchy raised skin with scales.
They may appear on the genitals and the tongue as well which is normally after someone has been sick with feverish conditions and as well as coughing. Other pustular psoriasis symptoms might be chills, joint pain, lowered appetite, and nausea.
The effects of these common symptoms of pustular psoriasis are usually quite dramatic in some cases. They pustule might start fusing together after a while followed by a period of drying and then peeling off altogether. This might eventually lead to the person’s body hair falling off as well.
There could be a long period of repeated fresh pustules appearing and drying for a weeks, keeping patients very uncomfortable.
But with the improved conditions, the fever, nausea, chills, and joint pains will normally go away but for some patients, their skin may remain bright red and the more normal skin symptoms of psoriasis will persist.
Just like other types of psoriasis, the common causes of pustular psoriasis is usually a combination of the patient’s genetic make-up and the environment; and these include-
#1- Stress brought on by emotional problems
#2- Taking and stopping of systemic drugs
#3- sometimes pregnancy
#4- Certain kinds of drugs like salicylates, iodine, penicillin, lithium, hydroxychloroquine, TNF alpha-blockers and vitamin D derivatives.
#5- Having very low levels of calcium in the blood stream
#6- Too much exposure to sunlight
There are quite a few different types of pustular psoriasis, 3 to be exact and this is according to the National Psoriasis Foundation and they are;
#1- Von Zumbusch Pustular Psoriasis
#2- Palmoplantar Pustulosis
Von Zumbusch Pustular Psoriasis also known as generalized pustular psoriasis is usually characterised by a painful reddening of a substantial part of the patient’s skin. This of course happens several hours after the formation of the pustules on the skin. They usually dry up and fall of; as we have seen in the symptoms of pustular psoriasis which can sometimes lead to more disruption of the skin’s protective role.
Palmoplantar Pustular Psoriasis also known as localised pustular psoriasis, is a kind of pustular psoriasis that forms on the soles of the feet and also on the palms of the hand. This usually starts with an initial reddening of the palms of the feet, followed by the formation of the pustules themselves. Then later they turn brown, dry up and then fall off.
Acropustulosis is a form of pustular psoriasis which occurs following the formation of lesions on the toes or the palms and fingers of the hands. This kind of pustular psoriasis can lead to painful deformities of the nails and can also affect the structure of the bones.
There are basically two major ways to go about pustular psoriasis treatment, and they are-
#1- Topical therapy- this involves the use of drugs or creams on the skin and include corticosteroids, coal tar, vitamin D3 derivatives, anthralin and retinoids. These drugs are quite powerful and have side effects of some people due to different genetic make-up. In some case doctors have found it more helpful to use the drugs in combinations and no single drug used for a prolonged period of time.
#2- Systemic therapies- this involves drugs taken into the body and these includes acitretin, methotrexate and cyclosporine.
There is also a 3rd form of cure for pustular psoriasis;
#3- Light therapy- This involves the use of Ultraviolet-B and narrow-band UV-B light on the affected areas. This is usually used in combination with topical drugs.
Also, it’s worth noting that people with Von Zumbusch Pustular Psoriasis (generalized pustular psoriasis) are sometimes admitted to the hospital. This is to ensure that they have adequate fluid intake and bed rest.
In the hospital, it will also be easy for the medical staff to monitor them and make sure that they don’t lose a lot body heat and or put too much strain on the heart.
There are quite a few psoriasis home cure and psoriasis home remedies for pustular psoriasis that work well for patients.
For example, the extracts from tree barks can be very effective for some people. Sufferers can also apply bland compresses to the areas of the body affected. They can also apply salt water solutions or take salt water bath and oatmeal bath to help soothe and heal the affected areas.
When scales form, you remove them by using soft cloth, and remember to apply an oil rich moisturizer to keep your skin form drying up and peeing later.
For most people in most cases this all they might ever need to treat pustular psoriasis.
Other natural and home cure for pustular psoriasis can include, diet changes, supplements, and or stress reducing techniques that have been proven to help reduce some of the symptoms. Most of these home remedies can be used quite comfortably at home. They are not much different from the usual natural cure for psoriasis.
Some of the ways to prevent pustular psoriasis include-
#1- Individual should try and avoid smoking, being exposed to too much sunlight and also lower stress in their life by making important lifestyle changes as needed.
#2- Minimize or do away completely with alcohol if you can. It’s been noted that for younger people, alcohol is high risk factor.
#3- There are no universally agreed dietary and supplements restrictions for pustular psoriasis but using your common sense and judgment to eat well-balanced diet rich in all classes of nutrients that your body needs in accordance with your age.