Generalized pustular psoriasis. A review of 63 cases

Arch Dermatol. 1991 Sep;127(9):1339-45.


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.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Adult
  • Child
  • Chronic Disease
  • Female
  • Glossitis, Benign Migratory / pathology
  • Humans
  • Infant
  • Joints / pathology
  • Length of Stay
  • Male
  • Middle Aged
  • Muscles / pathology
  • Pain / pathology
  • Psoriasis / classification
  • Psoriasis / drug therapy
  • Psoriasis / pathology*
  • Retrospective Studies
  • Skin Diseases, Vesiculobullous / pathology