1,951 results match your criteria Psoriasis Pustular

Combination Therapy with Apremilast and Biologics for Psoriasis: A Systematic Review.

Am J Clin Dermatol 2022 Jun 23. Epub 2022 Jun 23.

Department of Dermatology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Nielsine Nielsens Vej 9, 2300, Copenhagen, Denmark.

Background: The evidence for adding small-molecule drugs to an ongoing biologic treatment is sparse, but combination therapies appear to be advantageous in appropriately selected patients with psoriasis. To our knowledge, efficacy and safety of combination therapy with apremilast and biologics has not previously been reviewed.

Materials And Methods: A literature search was performed on Medline (PubMed), Embase, Web of Science, and the Cochrane Library. Read More

View Article and Full-Text PDF

Generalized Pustular Psoriasis in Pregnancy: Current and Future Treatments.

Am J Clin Dermatol 2022 Jun 15. Epub 2022 Jun 15.

Department of Dermatology, Gifu University Graduate School of Medicine, 1-1, Yanagido, Gifu, 501-1194, Japan.

Generalized pustular psoriasis (GPP) is a rare, severe neutrophilic skin disease characterized by sudden widespread eruption of sterile pustules with or without systemic symptoms. GPP may be life threatening in cases with severe complications such as cardiovascular failure, acute respiratory distress syndrome, and serious infections. Impetigo herpetiformis (IH) is a GPP that is induced and exacerbated by pregnancy and occurs most frequently during the last trimester. Read More

View Article and Full-Text PDF

Beyond plaque psoriasis - pathogenesis and treatment of other psoriasis phenotypes.

Curr Opin Rheumatol 2022 Jun 10. Epub 2022 Jun 10.

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma, Barcelona, Spain.

Purpose Of Review: Psoriasis vulgaris is the commonest presentation of psoriatic disease, but morphologic variants such as pustular psoriasis (PP) and a closely related disease, pityriasis rubra pilaris (PRP), have been known for a long time, have been associated with rheumatologic manifestations indistinguishable from psoriatic arthritis (PsA) that may go unrecognized, and often represent a therapeutic conundrum. There is recent evidence that underlying genetic and pathogenetic differences may provide the basis for newer therapeutic approaches.

Recent Findings: This narrative review highlights the clinical, genetic and pathogenetic characteristics of PP and PRP, their association with PsA and recent developments in their treatment, especially with biologic agents targeting IL-36 and other cytokines of pathogenic relevance. Read More

View Article and Full-Text PDF

Efficacy of adalimumab in pediatric generalized pustular psoriasis: case series and literature review.

J Dermatolog Treat 2022 Jun 20:1-7. Epub 2022 Jun 20.

Department of Dermatology, School of Medicine, ZhongDa Hospital, Southeast University, Nanjing, PR China.

Background: Generalized pustular psoriasis (GPP) is a rare, severe, and sometimes fatal form of childhood psoriasis. The first line therapies include acitretin, cyclosporin A, and methotrexate which take effect slowly and have varying long-term side effects for children. Recently, the anti-tumor necrosis factor-alpha (TNF-α), adalimumab has shown efficacy in adult patients with pustular psoriasis; however, there is lack of evidence of its usage in the pediatric population. Read More

View Article and Full-Text PDF

Generalized pustular psoriasis: the new era of treatment with IL-36 receptor inhibitors.

J Dermatolog Treat 2022 Jun 21:1-8. Epub 2022 Jun 21.

Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal.

Generalized pustular psoriasis (GPP) is a rare yet severe variant of psoriasis, characterized by the eruption of superficial sterile pustules that appear suddenly and widely distributed, potentially life-threatening. It more commonly presents through recurrent acute flares triggered by stress, corticosteroid withdrawals, pregnancy, or infections. The pathogenesis of this disease is yet to be fully understood. Read More

View Article and Full-Text PDF

Line-field confocal optical coherence tomography (LC-OCT) as a new tool for non-invasive differential diagnosis of pustular skin disorders.

J Eur Acad Dermatol Venereol 2022 Jun 13. Epub 2022 Jun 13.

Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy.

Background: The spectrum of pustular skin disorders (PSD) is large and particularly challenging, including inflammatory, infectious and amicrobial diseases. Moreover, although pustules represent the unifying clinical feature, they can be absent or not fully developed in the early stage of the disease. The line-field confocal optical coherence tomography (LC-OCT) is a recently developed imaging technique able to perform a non-invasive, in vivo, examination of the epidermis and upper dermis, reaching very high image resolution and virtual histology. Read More

View Article and Full-Text PDF

Role of IL-36 cytokines in psoriasis and other inflammatory skin conditions.

Cytokine 2022 Aug 6;156:155897. Epub 2022 Jun 6.

Immunology Discovery, Janssen Research and Development, San Diego, CA 92121, USA. Electronic address:

The IL-36 family of cytokines includes three pro-inflammatory agonists (IL-36α, IL-36β, and IL-36γ) and a receptor antagonist (IL-36Ra), which bind and signal through a heterodimeric receptor composed of IL-36R and the IL-1R accessory protein (IL-1RAcP). Individuals with inactivating mutations in the gene encoding IL-36Ra develop generalized pustular psoriasis, a severe form of psoriasis, a finding which clearly links dysregulated IL-36 pathway activation to inflammatory skin conditions. The purpose of this review is to highlight the cellular source of IL-36 cytokines, the effects of IL-36 signaling across cell types, and the association of IL-36 to a spectrum of inflammatory skin diseases including various forms of psoriasis as well as hidradenitis suppurativa, atopic dermatitis, and allergic contact dermatitis. Read More

View Article and Full-Text PDF

Demographic aspects, clinical characteristics, and therapeutic approaches in geriatric psoriasis: A study from a tertiary center.

Dermatol Ther 2022 Jun 9:e15628. Epub 2022 Jun 9.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Geriatric psoriasis, due to its unusual clinical manifestations and higher rates of systemic complications in this age group, is a challenging issue for dermatologists. Therefore, we aimed to provide an overview of the epidemiological, clinical and therapeutic consequences among patients aged over 60 years with psoriasis in a referral center in Iran.

Materials And Methods: This cross-sectional study was conducted on 156 patients over 60 years with the definitive diagnosis of psoriasis that were referred to our center between 2015 and 2019. Read More

View Article and Full-Text PDF

Generalized pustular psoriasis: overview of the status quo and results of a panel discussion.

J Dtsch Dermatol Ges 2022 06 8;20(6):753-771. Epub 2022 Jun 8.

Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany.

Generalized pustular psoriasis (GPP) is a rare, severe, potentially life-threatening, autoinflammatory, neutrophilic skin disease that may be accompanied by fever and leukocytosis. This paper describes the current state of knowledge on GPP in terms of classification, (differential) diagnosis and prevalence. We present a comparison of the genetics and pathoimmunology of GPP and psoriasis vulgaris with the central mechanisms of autoimmunology and autoinflammation. Read More

View Article and Full-Text PDF

Metabolic syndrome-related SNPs in HLA and TNF7L2 may be risk factors for generalized pustular psoriasis in Chinese Han population.

Skin Health Dis 2021 Jun 2;1(2):e18. Epub 2021 May 2.

Department of Dermatology Affiliated Hospital of Inner Mongolia Medical University Hohhot Inner Mongolia China.

Background: Generalized pustular psoriasis (GPP) is a rare and severe type of psoriasis. Previous studies have reported that metabolic syndrome and its components have been associated with psoriasis.

Objective: To investigate the association of metabolic syndrome-related single-nucleotide polymorphisms (SNPs) and GPP in Chinese Han population. Read More

View Article and Full-Text PDF

Clinical characteristics and management of acute generalized exanthematous pustulosis with haemodynamic instability.

Skin Health Dis 2021 Dec 15;1(4):e74. Epub 2021 Nov 15.

Department of Dermatology University of Texas Southwestern Medical Center Dallas Texas USA.

Background: Acute generalized exanthematous pustulosis (AGEP) is a severe pustular drug eruption with rare reports of haemodynamic instability.

Objective: To describe the clinical characteristics, management, and outcomes of patients with AGEP-associated haemodynamic instability.

Methods: This retrospective case series identified adult patients diagnosed with AGEP who had haemodynamic instability from November 2012 to February 2020 that were seen at two academic teaching hospitals with roles as a burn centre and tertiary referral centre at the University of Texas Southwestern Medical Center in Dallas, TX USA. Read More

View Article and Full-Text PDF
December 2021

Natalizumab-Induced Pustular Psoriasis of Palms and Soles.

Dermatol Pract Concept 2022 May 1;12(2):e2022088. Epub 2022 Apr 1.

Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy.

View Article and Full-Text PDF

Efficacy and Safety of Certolizumab Pegol in Japanese Patients with Generalized Pustular Psoriasis and Erythrodermic Psoriasis: 52-Week Results.

Dermatol Ther (Heidelb) 2022 Jun 27;12(6):1397-1415. Epub 2022 May 27.

Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan.

Introduction: We report an exploratory analysis of the efficacy and safety of certolizumab pegol (CZP) in Japanese patients with generalized pustular psoriasis (GPP) and erythrodermic psoriasis (EP) (NCT03051217).

Methods: Patients ≥ 20 years with GPP or EP were randomized 1:1 to open-label CZP 400 mg every 2 weeks (Q2W) or 200 mg Q2W (400 mg weeks 0/2/4) for 16 weeks; patients who achieved "much improved" or "very much improved" on the Global Improvement Score (GIS; for GPP) or a PASI 50 response (≥ 50% reduction from baseline Psoriasis Area and Severity Index; for EP) continued to week 52. Efficacy outcomes assessed included Clinical Global Impression of Improvement (CGI-I), Dermatology Life Quality Index (DLQI 0/1), and Itch Numeric Rating Scale (INRS 0). Read More

View Article and Full-Text PDF

Pustular psoriasis of pregnancy: Clinical and genetic characteristics in a series of eight patients and review of the literature.

Dermatol Ther 2022 May 22:e15593. Epub 2022 May 22.

Laboratory of Molecular and Functional Genetics, Faculty of Sciences of Sfax, Sfax University, Sfax, Tunisia.

Pustular psoriasis of pregnancy (PPP) can lead to life-threatening complications. The objective of this study is to report clinical and genetic spectrum, prognostic factors and management options. A retrospective study was designed including eight PPP patients. Read More

View Article and Full-Text PDF

Symptom Experience and Content Validity of the Psoriasis Symptom Scale (PSS) in Patients with Generalized Pustular Psoriasis (GPP).

Dermatol Ther (Heidelb) 2022 Jun 19;12(6):1367-1381. Epub 2022 May 19.

Baylor Scott & White Health, Dallas, TX, USA.

Introduction: We sought to understand key symptoms of generalized pustular psoriasis (GPP) and to confirm the relevance to patients and content validity of the Psoriasis Symptom Scale (PSS) in GPP.

Methods: A targeted literature review and clinical expert interviews were conducted as background research. Patients were interviewed individually (involving concept elicitation and cognitive interviews), and a separate patient workshop was conducted to determine disease-specific symptoms of importance. Read More

View Article and Full-Text PDF

Real-world data on the clinical use of secukinumab in pediatric generalized pustular psoriasis: A 48-week retrospective study.

J Am Acad Dermatol 2022 May 16. Epub 2022 May 16.

Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fujian, China. Electronic address:

View Article and Full-Text PDF

Economic Burden of Generalized Pustular Psoriasis in Sweden: A Population-Based Register Study.

Psoriasis (Auckl) 2022 5;12:89-98. Epub 2022 May 5.

Department of Public Health and Clinical Medicine, Dermatology, Umeå University, Umeå, Sweden.

Background: Generalized pustular psoriasis (GPP), which can occur with or without psoriasis vulgaris (PV), is a severe form of pustular psoriasis with potentially life-threatening symptoms. GPP is also associated with several comorbidities, which further adds to the burden of disease. This study investigates the economic burden of disease in patients with GPP. Read More

View Article and Full-Text PDF

Adalimumab-Induced Psoriasis with Severe Alopecia.

Skinmed 2022 30;20(2):136-138. Epub 2022 Apr 30.

Division of Dermatology, Faculty of Medicine, Lebanese University, Beirut, Lebanon;

A 52-year-old woman with a 10-pack-year smoking history presented with serious hair loss. She had a 10-year history of Crohn's disease associated with arthritis, for which she had been taking adalimumab. After 2 months of this treatment, she developed pustular lesions on her palms, soles, and scalp. Read More

View Article and Full-Text PDF

A Distinct Immature Low-Density Neutrophil Population Characterizes Acute Generalized Pustular Psoriasis.

J Invest Dermatol 2022 Apr 29. Epub 2022 Apr 29.

Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China; Institute of Psoriasis, Tongji University, Shanghai, China. Electronic address:

View Article and Full-Text PDF

First-Trimester Impetigo Herpetiformis Leads to Stillbirth: A Case Report.

Dermatol Ther (Heidelb) 2022 May 2;12(5):1271-1279. Epub 2022 May 2.

Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261, Huansha Road, Hangzhou, China.

Introduction: Pustular psoriasis of pregnancy (PPP), also known as impetigo herpetiformis (IH), is a rare variant of generalized pustular psoriasis (GPP) in pregnancy. It typically occurs in the third trimester and is a life-threatening condition for both the pregnant mother and the fetus if not diagnosed and treated promptly. Drug-induced PPP has been reported in sporadic case reports. Read More

View Article and Full-Text PDF

Identifying patients with deteriorating generalized pustular psoriasis: Development of a prediction model.

J Dermatol 2022 May 2. Epub 2022 May 2.

Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.

Generalized pustular psoriasis (GPP) is a life-threatening condition; however, little is known about the factors that can predict GPP patients manifesting a deteriorating course. To investigate the demographics and clinical features of adult inpatient GPP and propose a prediction model for detecting fatal GPP (fGPP) and GPP requiring intensive care unit admission (iGPP) patients, a nationwide population-based retrospective cohort study was conducted. The adult inpatients with GPP from January 2007 to December 2020 were assessed. Read More

View Article and Full-Text PDF

Time to accurately determine the burden of generalized pustular psoriasis at the population level.

Br J Dermatol 2022 Jun 28;186(6):919-920. Epub 2022 Apr 28.

Department of Dermatology, AP-HP, Hôpital Saint-Louis, Laboratory of Genetic Diseases, INSERM U1163, Imagine Institute, Université de Paris, Paris, France.

View Article and Full-Text PDF

A review of IL-36: an emerging therapeutic target for inflammatory dermatoses.

J Dermatolog Treat 2022 Apr 26:1-12. Epub 2022 Apr 26.

Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Background: IL-36 cytokines are members of the IL-1 superfamily. Increasing evidence in the IL-36 pathway demonstrates their potential as a therapeutic target for treating inflammatory skin diseases, such as generalized pustular psoriasis (GPP).

Objective: A narrative review was written to further study preclinical and clinical evidence for the role of IL-36 in psoriasis, atopic dermatitis (AD), hidradenitis suppurativa (HS), acne, autoimmune blistering diseases, and neutrophilic dermatoses. Read More

View Article and Full-Text PDF

Population pharmacokinetics analysis of guselkumab in healthy subjects and patients with psoriatic arthritis, plaque psoriasis and palmoplantar pustulosis.

Br J Clin Pharmacol 2022 Apr 25. Epub 2022 Apr 25.

Clinical Pharmacology and Pharmacometrics, Janssen Research & Development, a division of Janssen Pharmaceutica NV, Beerse, Belgium.

Aims: Guselkumab, a monoclonal antibody that binds to the p19 subunit of interleukin 23, is approved for the treatment of plaque psoriasis (PsO) and psoriatic arthritis (PsA), palmoplantar pustulosis (PPP), generalized pustular psoriasis, and erythrodermic psoriasis in various countries. The purpose of this analysis was to develop a comprehensive population pharmacokinetic (PK) model for guselkumab to determine whether PK differs across different disease populations and healthy subjects.

Methods: A nonlinear mixed-effects modelling approach was used to analyse 23 097 serum PK samples obtained from 2623 healthy subjects and patients with PsO, PsA and PPP across 9 phase 1-3 clinical trials. Read More

View Article and Full-Text PDF

Bilateral Vitreous Hemorrhage in a Young Man with Pustular Psoriasis.

Skinmed 2022 28;20(1):69-71. Epub 2022 Feb 28.

Department of Ophthalmology, Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.

A 25-year-old man consulted us with a severe exacerbation of pustular psoriasis for 10 days (Figure 1). The patient had pustular psoriasis for the last 12 years. During his hospital stay, he suffered sudden painless and profound loss of vision in both eyes. Read More

View Article and Full-Text PDF