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Generalized pustular psoriasis: a review and update on treatment
Author(s) -
Hoegler K.M.,
John A.M.,
Handler M.Z.,
Schwartz R.A.
Publication year - 2018
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.14949
Subject(s) - medicine , generalized pustular psoriasis , pustular psoriasis , psoriasis , dermatology , methotrexate , immunology
Generalized pustular psoriasis (GPP) is a subtype of pustular psoriasis characterized by painful and occasionally disfiguring cutaneous manifestations with sepsis‐like systemic symptoms. Affecting any age and race, GPP can occur with other forms of psoriasis or by itself. Stimuli for flares include medications, infections and environmental triggers. The interleukin family and caspase recruitment domain family have been implicated in its pathogenesis. Other forms of pustular psoriasis include impetigo herpetiformis, palmoplantar pustular psoriasis, annular pustular psoriasis and acrodermatitis continua of Hallopeau. Treatment is not well established, but includes the use of retinoids, methotrexate, cyclosporine, corticosteroids, TNF ‐alpha inhibitors, topical therapy and phototherapy. The use of TNF ‐alpha inhibitors may result in the formation of antidrug antibodies and should be administered with methotrexate.