Generalized Pustular Psoriasis: A Case Report

Psoríase Pustular Generalizada: A Propósito de um Caso Clínico

Abstract

Generalized pustular psoriasis (GPP), or Von Zumbush
psoriasis, is a rare and potentially fatal variant of psoriasis.
It is characterized by a generalized exanthema with multiple pustular lesions resembling pus but sterile, with posterior skin detachment. Frequent triggering factors may include infection, electrolyte changes, or drugs, including inadequate weaning from corticosteroids. The diagnosis relies on histopathologic features such as organized pustules, called spongiform pustules of Kogoj. There should be immediate discontinuation of the offending factor. Treatment with retinoids, cyclosporine and methotrexate have been used as first-line therapies.

We report the case of a woman who presented with generalized pustular exanthema after corticosteroids. A skin biopsy was performed and established the diagnosis of GPP. The patient underwent therapy with acitretin, with clinical improvement.

This case highlights a rare subtype of psoriasis and alerts
to the risk of indiscriminate use of corticotherapy, that can potentially exacerbate pre-existing conditions.