Pustular Psoriasis: What You Should Know!

Psoriasis dry skin texture detail background of an adult maleWhile many people understand psoriasis is a skin disorder characterized by thick scaly plaques on the skin, the disease can actually manifest itself in a number of different forms. Pustular psoriasis, for example, is a chronic inflammatory condition that appears on the skin as blisters of noninfectious pus surrounded by red skin. “The appearance is quite different than the pink, scaly plaques characteristic of plaque psoriasis, the more common form of the disease,” says Dr. Adam Mamelak, board-certified dermatologist in Austin, Texas. But both forms of the disease can appear at the same time and in some cases, or one form may follow the other.

The inflammation leading to pustular psoriasis is thought to be an autoimmune response. But the pustular psoriasis outbreaks can be triggered by a number of medical or environmental factors, such as medications, irritating topical agents, overexposure to the sun, stress, and even pregnancy. “The pink skin and pus-filed blisters may look like a skin infection,” says Dr. Mamelak. “But this pus is actually a collection of white blood cells in the top layers of the skin, and the condition is not contagious.”

Dr. Mamelak treats patients with psoriasis at Sanova Dermatology. As he explains, there are three types of pustular psoriasis:

  • Von Zumbusch. This type of pustular psoriasis appears as widespread areas of reddened skin that become painful and tender. Over the next day or two, the characteristic pustules dry. This outbreak can be accompanied by other symptoms, such as fever, shivers, itching, headache, muscle weakness, and sometimes joint pain. When symptoms become this severe, the pustules and peeling skin can appear all over the body. This type of psoriasis typically requires hospitalization to keep patients hydrated and for treatment.
  • Palmoplantar pustulosis. “In this variant of the disease, pustules appear typically appear on the palms and the soles of the feet,” says Dr. Mamelak. At first, these pustules appear in a studded pattern on top of red patches of skin. The reddened skin then turns brown, peels, and becomes crusty. This form of pustular psoriasis is often cyclical.
  • Acropustulosis. This rare form of the disease appears as skin lesions on the tips of the fingers and toes, often following an injury to the skin or an infection. These painful lesions can be disabling, and in severe cases, the disease can even cause bone changes.

Patients no longer have to suffer from the physical and emotional discomfort that comes with psoriasis. Several good and effective treatments are available, and your dermatologists may opt to use more than one at the same time, or in sequence. “Phototherapy exposes the skin to a special ultraviolet light for therapeutic effect,” says Dr. Mamelak. There is also medication in the form of creams, pills and shots available, that can lead to disease remission and clear skin.

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