Generalized pustular psoriasis (GPP) is marked by sterile pustules and it presents as a potentially serious condition that needs to be diagnosed and treated promptly. The available treatment options are limited; however, novel medications now approved seek to manage pustular outbreaks. Furthermore, there is a great deal of variation in the length of each flare-up and the time between pustular episodes. Fever, chills, lethargy, anorexia, nausea, and excruciating pain are common systemic symptoms associated with flare-ups of generalized pustular psoriasis. Lastly, pustules that develop during a GPP flare can persist for months, pose a serious risk to life, and frequently necessitate immediate medical attention.
GPP’s histology is characterized by red scaly patches and plaques, Munro’s microabscess (collection of neutrophils in the stratum corneum layer of the epidermis), hypergranulosis (increased thickness of the stratum granuslosum), suprapapillary thinning (thinning at the tips of the dermal papilla), increased vascularization of the dermal papilla, and elongation of the rete ridges.