Generalized pustular psoriasis. A review of 63 cases.
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.


METHODS
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.
Zelickson
B D
BD
Department of Dermatology, Mayo Clinic, Rochester, Minn. 55905.
Muller
S A
SA
D000208:Acute Disease; D000328:Adult; D002648:Child; D002908:Chronic Disease; D005260:Female; D005929:Glossitis, Benign Migratory / Q000473:pathology; D006801:Humans; D007223:Infant; D007596:Joints / Q000473:pathology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000473:pathology; D010146:Pain / Q000473:pathology; D011565:Psoriasis / Q000145:classification / Q000188:drug therapy / Q000473:pathology*; D012189:Retrospective Studies; D012872:Skin Diseases, Vesiculobullous / Q000473:pathology