Pustular psoriasis is an uncommon form of psoriasis. Psoriasis is a common skin disease that affects the life cycle of skin cells. Generalised pustular psoriasis is a rare form of psoriasis, which presents as widespread pustules on a background of red and tender skin. Pustular psoriasis is uncommon in the United States. Pustular psoriasis affects all races. The average age of those affected is 50 but the range is wide and rarely it can affect children. Pustular psoriasis of the palms and soles is usually chronic and may be associated with bone or joint inflammation. The palms or soles are red with white or yellow pustules. Pustular psoriasis also can be generalized, covering most of the body. It tends to go in a cycle–reddening of the skin followed by formation of pustules and scaling.
It is also known as sharp generalised pustular psoriasis of von Zumbusch. Von Zumbusch pustular psoriasis can be triggered by an infection. Initially the skin becomes dry, fiery red and tender. The patient may also have a fever, chills, headache, rapid pulse rate, and loss of appetite, nausea and muscle weakness. Psoriasis treatments aim to interrupt the cycle that causes an increased production of skin cells, thereby reducing inflammation and plaque formation. The ultraviolet (UV) light from the sun slows the production of skin cells and reduces inflammation. Sunlight helps reduce psoriasis symptoms in some people. Ultraviolet-B (UV-B) and narrow-band UV-B light: UV-B light is also used to treat psoriasis. UV-B is light with wavelengths of 290-320 nanometers (nm).
Topical treatments are corticosteroids, vitamin D-3 derivatives, coal tar, anthralin, or retinoids. Topical calcineurin inhibitors such as tacrolimus and pimecrolimus have been effective in some cases of pustular psoriasis limited to the palms and soles. Anthralin (Dritho-Scalp or Psoriatec) can remove scale and smooth skin, but it stains virtually anything it touches, including skin, clothing, countertops and bedding. Oral retinoid such as acitretin, derived from vitamin A. Other medications such as methotrexate, colchicine, ciclosporin, tioguanine and hydroxyurea have been used with some success. Biological therapies such as alefacept, etanercept and infliximab have been used with success at times. Oral retinoids, methotrexate, cyclosporine, 6-thioguanine, and hydroxyurea have been used with success.
Pustular Psoriasis Treatment and Prevention Tips
1. Sunlight helps reduce psoriasis symptoms in some people.
2. Soriatane, cyclosporine or methotrexate are often prescribed.
3. Ultraviolet-B (UV-B) and narrow-band UV-B light: UV-B light is also used to treat psoriasis.
4. Oral retinoid such as acitretin, derived from vitamin A.
5. Topical treatments are corticosteroids, vitamin D-3 derivatives, coal tar, anthralin, or retinoids.
6. Calcipotriene (Dovonex) is a prescription cream, ointment or solution containing a vitamin D analogue.