Sean Klepper M.D.
Artur Zembowicz M.D....
- 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.
- 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.