Pustular Psoriasis

Pustular psoriasis is a rare type of psoriasis. Individuals with pustular psoriasis have emphasized, raised bumps on the skin that contain pus, or pustules. The skin underneath and surrounding these bumps is red. Considerable parts of your skin may become red. You may become aware of some changes in your skin before, during or after an episode of the skin condition. Although pustular psoriasis may have different characteristics, its symptoms may also resemble other types of psoriasis.

Pustular psoriasis is categorized into one of many types based on your symptoms. Your symptoms may be acute, long term or somewhere in between. If you have acute pustular psoriasis, the condition is abrupt and severe. On the other hand, the chronic type is a long term condition. Generally, pustular psoriasis is found all over the body and indicates more than just skin problems. A generalized form with acute symptoms, fever, and a toxic reaction in your tissues is known as the von Zumbusch type. Ring-shaped symptoms have also been reported. This is often subacute or chronic, and individuals with this type oftentimes do not display symptoms other than skin problems. Pustules may be isolated on the palms and soles. The rarest type is the infantile or juvenile type, which develops in children.

There are several possible causes of pustular psoriasis. Infection may be a contributing factor. It is also implicated that having a history of chronic plaque psoriasis may precede pustular psoriasis. Similarly, having a family history of psoriasis makes one more prone to getting the skin condition. Environmental factors such as alcohol, drugs, infections, psychological stress, trauma and sunlight can exacerbate psoriasis in general. Certain medications and topical treatments like NSAIDs, beta blockers, zine pyrithione and anthralin may irritate the skin and worsen affected areas. Ironically, some treatments for regular psoriasis like phototherapy and natural sunlight can contribute to the development of pustular psoriasis. That being said, some treatments will work for some, and not for others. Finally, someone with cholestatic jaundice have a higher tendency to develop pustular psoriasis.

Treatment of Pustular Psoriasis

The generalized pustular type of psoriasis can be dangerous and a patient affected by the condition may need hospitalization. The goal in this case is to stop further loss of fluid, regulate body temperature and re-establish normal electrolyte levels. Typically, there is a reduced amount of calcium in the blood. Other alterations in the blood testing include high ESR, low plasma albumin and zinc, increased neutrophil count, increased lactate levels and lowered lymphocyte count.

Bland topical compresses are often applied to areas affected by the severe skin condition. The doctor may administer antibiotics if there is infection. In worse case scenarios or when repeated flare-ups have worn out the patient, systemic therapies are recommended. These are (and may not be limited to) oral medication like acitretin, colchicines, ciclosporin, methotrexate, tioguanine, hydroxyurea, PUVA and Phototherapy.

Because pustular psoriasis can be serious when severe, patients are often advised to take preventative steps (though there is not one exact preventative method that works for everyone). Try to avoid infection and if it occurs, speak with your doctor so you can get medicated immediately. Protect skin from exposure to sunlight and continue recommended daily hygiene  practices and maintenance treatments if advised by your doctor.