Pustular Psoriasis

Pustular psoriasis is one of the most easily recognizable forms of psoriasis. The white lesions that characterize the condition are full of pus, which is made of white blood cells. While pustular psoriasis looks like a very severe rash, it is neither an infection nor contagious. This condition is commonly experienced alongside plaque psoriasis, and while it can break out in a single area, it is also known to cover large portions of the body.

Causes and Symptoms

There is no known pustular psoriasis cause. The symptoms of the condition occur as the result of an immune system reaction. However, doctors have isolated several potential triggers. These include but are not limited to:

• Pregnancy
• Systemic steroids
• Emotional stress
• Some internal medications
• Irritating topical agents
• Infections
• Sudden withdrawal from some medications

Types of Pustular Psoriasis

All forms of pustular psoriasis are characterized by small, white pustules that appear most often on the knees and elbows. Symptoms often begin with skin reddening and tenderness, but within a few hours, blisters full of noninfectious pus begin to form. Over time, these blisters will become brown or crusty. If they peel off, the skin underneath may appear shiny or scaly.

There are three types of pustular psoriasis, each with its own symptoms and requiring different treatment strategies.

• Palmoplantar pustulosis, also known as PPP, is characterized by pustules on the palms of the hands and the soles of the feet. These pustular psoriasis symptoms are often cyclical.
• Von Zumbusch pustular psoriasis is a life-threatening form of the condition that requires urgent medical care. It appears as widespread areas of reddened skin, which eventual develops pustules. These pustules then dry, leaving the skin with a glazed appearance. Hospitalizations are often required for antibiotic treatment and rehydration. This form of pustular psoriasis is also associated with a rapid pulse rate, exhaustion, fever, chills, weight loss, and anemia.
• Acropustulosis is the rarest type of pustular psoriasis. It is characterized by lesions on the ends of fingers. These may also appear on the toes. These marks often appear after an injury or infections, and the lesions can be very painful.

Pustular Psoriasis Treatment Options

Pustular psoriasis treatments are often multifaceted. This means doctors will often combine or rotate treatments over time to help mitigate side effects from medications. Generalized pustular psoriasis, which focuses on preventing infection and fluid loss, typically combines methotrexate, acitretin, cyclosporine, and other medications. By contrast, localized pustular psoriasis utilizes topical treatments and PUVA ultraviolet light. Your doctor will recommend a psoriasis treatment based on your medical history and lifestyle. However, it is important to note that none of these medications are available without a doctor’s assistance. If you think you have this type of psoriasis, contact your dermatologist.

Pustular psoriasis is notoriously difficult to treat. If you think you have the condition, it is important to contact a board-certified dermatologist to receive the treatment you need. Psoriasis is a chronic and persistent condition, which means long-term care is often necessary. Contact one of our Minneapolis-area dermatology centers today to start your personalized treatment plan.

*Results may vary per patient. Services vary by location.