Pustular psoriasis is one of the rare forms of psoriasis. It consists of diffused pustules on an erythematous background. People suffering from this type of psoriasis have small blisters on the skin filled with fluid. The skin surrounding them is reddened. Just like regular psoriasis, the skin changes are noticeable with pustular psoriasis.
Depending on the length of this disease, there can be either acute or chronic pustular psoriasis and it can also be very severe if it covers the entire body because then it can affect the body’s ability to keep its temperature and fluid balance.
There are various types of pustular psoriasis. One of them is the generalized type, as noted above. This type causes toxic reactions in the tissues of the body and is known as the “von Zumbusch” type. Another is a ring-shaped type that makes a ring on the skin, usually a sub-acute or chronic. There is also palmoplantar pustulosis that has pustules both on hands and feet. A rare type of pustular psoriasis called infantile or juvenile-type is also affecting children around the age of 2 to 10. Girls are less affected than the boys.
This being an uncommon psoriasis, it affects less people per million. Men and women of all races are affected equally. There are many causes of this condition. If you are on high dose of steroids and then you abruptly stop taking them, it can happen. Some of the other drugs that can trigger the advent of pustular psoriasis are Lithium, trazodone, iodine topical preparations, etc. Also very strong skin irritants like coal tar, anthralin, etc. can cause it. Certain infections could also trigger this.
Depending on the intensity of the case, the treatment for pustular psoriasis can be made. Hospitalization could also be needed to maintain a decent fluid intake and maintain normal body temperature. You can undergo baths mixed with saltwater solution and compresses, oatmeal baths and other psoriasis treatments to heal the pustules and prevent secondary infection. You can also use topical agents for pustular psoriasis. Such agents include preparations made of coal tar, corticosteroids, anthralin and retinoids.
Pustular psoriasis can also be treated by light therapy. Sunlight or special UVB lamps or UVA lamps are used in this type of treatment. Psoralens, a medication that sensitizes one to the light are used along with UVA light in a therapy called PUVA. This is done because UVA light is not as strong as UVB light. Skin burning and or skin cancer can be possible side effects of this type of therapy.
Pustular psoriasis can also be treated by systemic therapy in the form of either retinoids or biologics such as Enbrel and Humira to help reduce the inflammatory response. Combination of systemic therapy with light therapy also produces a good response to treatment.
It is very important to know how and what triggers this condition to prevent it from happening. According to some researchers, this condition is commonly set off by infection, pregnancy, jaundice, hypocalcemia, sunlight, steroid medication withdrawal, calcipotriol and certain drug usage. Stress and tobacco smoking are also some of the triggers.