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September 1991

Generalized Pustular Psoriasis: A Review of 63 Cases

Author Affiliations

From the Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minn.

Arch Dermatol. 1991;127(9):1339-1345. doi:10.1001/archderm.1991.01680080075005

• Background.—  Sixty-three patients with generalized pustular psoriasis were hospitalized during a 29-year period. They were classified into four subgroups on the basis of onset and morphologic pattern of disease: acute (von Zumbusch), subacute annular, chronic (acral), and mixed. This division provides a better understanding of the variability of the disease and helps in choosing treatment.

Observations.—  The average age at onset was 50 years; male and female patients were affected about equally. In 11 patients, flares were precipitated by localized infections. Approximately one fourth of the patients had complications; most were superinfections. The average stay in the hospital was 30 days; factors correlating with a long hospitalization were hypocalcemia, female sex, and a previous history of psoriasis vulgaris or pustular psoriasis.

Conclusions.—  Whereas topical therapy was helpful, systemic medications were often needed. Coal tar, ultraviolet light, and psoralen—ultraviolet A may be effective; however, they must be used with caution, because they may exacerbate the disease.(Arch Dermatol. 1991;127:1339-1345)

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