Pustular Psoriasis

Pustular psoriasis is an uncommon form of psoriasis. People with pustular psoriasis have clearly defined, raised bumps on the skin that are filled with pus (pustules). The skin under and around these bumps is reddish. Pustular psoriasis may cause large portions of your skin to redden. The skin changes you might notice before, during, or after an episode of pustular psoriasis might be similar to those of regular psoriasis.

Pustular psoriasis. Image courtesy of Hon Pak, MD.

Pustular psoriasis. Image courtesy of Hon Pak, MD.

Pustular psoriasis is classified into one of several types, depending on your symptoms. Your lesions may be sudden (acute), long term (chronic), or somewhere in between (subacute). The generalized type affects your whole body with more than just skin tenderness. A generalized type with acute symptoms of fever, chills, nausea, headache, and joint pain is called the von Zumbusch type. Pustular psoriasis of the palms and soles is usually chronic and presents with red patches studded with white-to-yellow pustules. A ring-shaped (annular, or circinate) type has also been described. It is usually subacute or chronic, and people with this type do not usually have symptoms aside from the skin symptoms. Acrodermatitis continua is a rare type of pustular psoriasis that involves the fingertips. Fingernails may float away on lakes of pus. The lesions may be very painful and result in permanent nail destruction. The least common type is the juvenile, or infantile type, which occurs in children.