• Pustular lesions developed in 16% of our psoriatic inpatients treated with a modified Goeckerman regimen. The role of bacterial infection in the development of these lesions remains controversial. Representative lesions were cultured, and the recovered organisms were quantitated. We were not able to culture a significant number of bacteria from these lesions. Pustules were prone to develop during the summer months in hirsute patients, in patients with hyperhidrosis, and in patients in whom topical treatment of a more occlusive nature was applied. The male-female ratio was 4.8:1. Topical antibiotic treatment of these pustules in psoriatic patients appeared to be unwarranted since the lesions resolved when topical therapy was discontinued. These pustules appeared to be distinct from pustular psoriasis.
(Arch Dermatol 1987;123:890-892)