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What Is Pustular Psoriasis?

In This Article

1- What is Pustular psoriasis?The Secets Of Clear Healthy Skin

2- What Does Pustular Psoriasis Look Like?

3- What Causes Pustular Psoriasis?

4- What Are The Symptoms Of Pustular Psoriasis?

5- What Are The Types Of Pustular Psoriasis?

6- What Treatment Is Available For Pustular Psoriasis?

7- Pustular Psoriasis Prevention And Management

8- What Are The Pustular Psoriasis Complications?

9- References

What is Pustular psoriasis?

What Is Pustular Psoriasis?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.

What Does Pustular Psoriasis Look Like?

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?

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,

Secrets Of Clear Healthy Skin

Secrets Of Clear Healthy Skin

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

-Oral iodides

-Lithium or trazodone, and taking antidepressants

5- Pregnancy

6- Having an unusually low level of calcium in the blood stream; a condition known as Hypocalcemia.

7- Jaundice

What Are The Symptoms Of Pustular Psoriasis?

  • This condition primarily affects adults more than children.
  • Head aches
  • Fever
  • Chills
  • Joint Pain
  • Decreased appetite
  • Nausea
  • The affected areas of the skin are usually red and white pustules surrounding them.
  • In most patients, within 2 to 3 months, they go into a phase that involves the loss of their hair.

What Are The Types Of Pustular Psoriasis?

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.

What Treatment Is Available For Pustular Psoriasis?

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


-Systemic corticosteroids

-Methotrexate and


-Acropustulosis treatment

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,

-Supplements, and

-Stress-reducing techniques to help reduce symptoms.

It’s also good to note that the FDA has not approved these alternative pustular psoriasis remedies with good reason because they have not been clinically tested.

Pustular Psoriasis Prevention And Management

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.

Psoriasis Away/The Secrets Of Clear Healthy Skin

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.

-The combinations of psoralen and ultraviolet A (UVA) can be used but not at the early stages. Your doctor will determine when to start applying this and at what rate and quantity.

What Are The Pustular Psoriasis Complications?

-Hair loss

-Nail loss

-Secondary bacterial infection of the skin

-Poor circulation and general toxicity may lead to liver failure.

-Malabsorption and malnutrition may occur

-Death due to cardiac arrest or acute respiratory distress syndrome


University Of Maryland Medical Centre