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Profile: Pustular Psoriasis

Definition: A very specific and rare form of psoriasis is characterised by the formation of numerous small pustules, filled with a yellowish, non-infectious (aseptic) pus but often highly inflammatory, on the red patches. Pustular psoriasis itself is divided into three categories: palmo-plantar pustular psoriasis with pustules primarily located on the palms of the hands and/or soles of the feet (affecting 5% of people with psoriasis), generalised pustular psoriasis (Von Zumbusch pustular psoriasis) with pustules covering almost the entire body (a rare but severe form with a prevalence of 2 cases per 1 million people in France) accompanied by numerous extra-cutaneous manifestations (fever, chills, severe itching, anaemia, muscle weakness, joint pain, etc.), and nail pustular psoriasis characterised by small holes in the nail, sometimes accompanied by detachment, thickening or deformation of the nail. Contrary to popular belief, this type of psoriasis is not caused by bacteria or poor body hygiene.

Internal and external causes: Genetic predisposition; disruption of the immune system; abrupt cessation of corticosteroid-based treatments in patients with plaque psoriasis; administration of certain medications (aspirin derivatives, lithium, etc.).

How to reduce or eliminate: Topical use of dermocorticoids (cream, lotion, ointment); treatment through phototherapy; prescription of systemic medications (methotrexate, cyclosporine or acitretin) in cases where dermocorticoids are ineffective; use of urea-based nail varnish or corticosteroid injections under the nails (pustular psoriasis of the nails); prescription of retinoid-derived medications and immediate hospitalisation of the patient (generalised pustular psoriasis).

Preventative steps to take: /