Clinical Features:

• Occurs in generalized and localized forms.
• Generalized pustular psoriasis (of Zumbusch):
  • Acute eruption of small pustules on the trunk and extremities following a prodrome of fever
  • The skin surrounding the pustules is erythematous
  • The episodes of fever and pustulation are typically recurrent and are accompanied by systemic symptoms.
  • May be idiopathic or secondary to a variety of triggers, such as viral or streptococcal infection, cessation of corticosteroid therapy, pregnancy, hypocalcemia or phototherapy.
• Localized (mixed) pustular psoriasis:
  • Development of pustules on pre-existing psoriatic plaques
  • Most often occurs in acute flares or following treatment
• Palmoplantar pustulosis: See separate textbook entry.

Histologic Features:

• Intraepidermal macropustules with accompanying keratinocyte necrosis
• The classic features of psoriasis are often poorly developed, unless the lesion has arisen on the background of a pre-existing psoriatic lesion.

Cases associated with this book:

Pustular psoriasis
Author: Artur Zembowicz M.D. Ph.D.

Conference: DermatopathologyConsultations.com Teaching Collection