The pustules are red and scaly and in some cases may cover a large part of the body.
People who have widespread pustules need to seek immediate medical attention, as the condition can be life-threatening.
This article looks at pustular psoriasis and its symptoms, causes, diagnosis, and treatment.
Reproduced with permission from © DermNet New Zealandwww.dermnetnz.org2023.
It also discusses ways you might be able to prevent this dangerous form of psoriasis.
Reproduced with permission from DermNet New Zealandwww.dermnetnz.org2023.
In plaque psoriasis, dry, red lesions covered with silvery-white scales develop on the skin.
With pustular psoriasis, the lesions form pus-filled blisters called pustules.
There are three major types of pustular psoriasis.
Each of these types differ in location, severity, and medical response.
Pustular psoriasis looks different depending on which punch in you have.
Generally speaking, the pustules appear as small white blisters similar to pimples but without the inflamed borders.
They are usually closely clustered and set atop a patch of red, inflamed skin.
The pustules easily erupt and can be extremely itchy and painful.
After breaking open, the pustules form crusty, peeling lesions that heal slowly.
What Causes Pustular Psoriasis?
Allpsoriatic diseasesare characterized by an abnormalautoimmune responsein which the immune system suddenly and inexplicably attacks normal skin cells.
The ensuinginflammationprompts the cells to multiply at an accelerated rate.
This causes them to build one on top of the other faster than they can be shed.
The cause of pustular psoriasis is poorly understood.
In addition to triggering plaque, the inflammation causes the rapid death of defensivewhite blood cells.
This, paired with the accumulation of lymph fluid, is what causes pus to form.
Pustular psoriasis is associated with specific triggers that can give rise to acute episodes known asflares.
In many cases, a person with plaque psoriasis will suddenly develop pustular psoriasis in response to these triggers.
Pustular psoriasis triggers may include:
Stress can also trigger recurrent flares or exacerbate an existing episode.
Other episodes are idiopathic, meaning they are of no known origin.
This is referred to as thedifferential diagnosis.
One of the ways to do this is to send a pus sample to apathologistfor evaluation.
Both PPP and ACH are usually treated at home, while Von Zumbusch psoriasis almost always requires hospitalization.
Sometimes, one treatment is all that is needed to handle the acute pustular symptoms.
This may be used if the pustules are less responsive to treatment.
The preparation has astringent and antibacterial properties that can reduce swelling and aid with healing.
Oral retinoids are the most effective treatment for generalized pustular psoriasis and are considered the first-line option.
Methotrexate or cyclosporine may be added in severe cases.
Prevention
Pustular psoriasis can be extremely distressing both physically and emotionally.
There is little you might do to avoid getting pustular psoriasis since the causes are so varied and multidimensional.
In some types, these blisters may appear over large parts of the body.
When this happens, you should seek immediate medical attention.
Like other types of psoriasis, pustular psoriasis can be triggered by things like medications and skin infections.
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