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Background

This variant of psoriasis is a distinct disease entity. It is rare and dramatic presentation of numerous pustules associated with fever and other constitutional symptoms. There may be associated arthritis, erythroderma, hypocalcemia, and migratory glossitis of the tounge.

Clinical Settings

Long history of psoriasis with provacative agent Sunlight, UV radiation, alcohol, malignancy, hypocalcemia, NSAIDS, lithium, iodides, beta blockers, penicillin, sulfonamides, progesterone
Preceding psoriasis with atypical features Onset is usually late in life
Arising without preexisting psoriasis  

Variants of Pustular Psoriasis

Von Zumbusch Most common variant
Explosive onset
30% mortality
Impetigo herpetiformis Flexural surfaces with centripetal spread
May be a variant of psoriasis in pregnancy
Fetal mortality is high
Acral variant Arises in acrodermatitis continua
Localized to one or more digits with dystrophy of nails
Exanthematic form  
Annular variant  
Localized form Pustular psoriasis arising in preexisting plaques of psoriasis

The histology shows intraepidermal pustules with only mild epidermal hyperplasia, unlike classical psoriasis. There are dilated blood vessels within the superficial dermis associated with lymphocytes.

Fitzpatrick's Dermatology in General Medicine. 5th Edition. McGraw-Hill. 1999.


Commonly Used Terms

See Psoriasis.


Internet Links

Last Updated 6/22/2001

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Copyright 2001 The Doctor's Doctor