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October 2006

Cyclosporine Resolves Generalized Pustular Psoriasis of Pregnancy

Arch Dermatol. 2006;142(10):1361-1375. doi:10.1001/archderm.142.10.1373

Generalized pustular psoriasis of pregnancy (GPPP) is a rare form of psoriasis in which groups of sterile pustules arise at the periphery of erythematous patches of skin. Associated symptoms may include diarrhea, fever, malaise, and convulsions. We report the first case of GPPP treated successfully with cyclosporine in a black woman with multiple sclerosis and no history of pustular psoriasis.

A 20-year-old gravida 3, para 0 black woman at 28 weeks’ gestation with a history of multiple sclerosis and recurrent spontaneous abortions presented with a 1-month history of increasingly widespread macular erythematous eruptions and associated peripheral pustules, sparing the face and mucosal surfaces (Figure 1A). She also complained of generalized malaise, pruritus, muscle weakness, and myalgias. She had a slightly elevated temperature at 37.5°C and the rest of her physical examination findings were unremarkable.