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October 1972

Generalized Pustular Psoriasis

Author Affiliations

Cambridge, Mass

Arch Dermatol. 1972;106(4):599. doi:10.1001/archderm.1972.01620130105036

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To the Editor.—  In a recent article entitled "Generalized Pustular Psoriasis" (Arch Dermatol 105:711-716, 1972), Landry and Muller describe patients with generalized pustular psoriasis. Patient 1 was a 28-year-old man who had had rheumatic fever treated with penicillin. Although undoubtedly a coincidence, I have had four patients with recalcitrant localized pustular psoriasis and rheumatic fever who have had regimens of intermittent penicillin prophylaxis without flare in the disease while taking the drug. They had been resistant to all therapy. I wondered if the rheumatic fever may have conditioned the patients to this process. Years ago, Dr. Walter Bauer, discussing the so-called "group diseases," suggested that there may be a relationship between patients with early rheumatic fever in childhood who later developed lupus in their 30s and scleroderma or dermatomyositis in their senescence. Perhaps a computer study may show a higher incidence of rheumatic fever, with or without drug

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