Pustular Psoriasis Facts
Pustular psoriasis is an uncommon form of psoriasis. Pustular psoriasis appears as clearly defined, raised bumps that are filled with a white, thick fluid composed of white blood cells. This purulent exudate is commonly called pus. The skin under and around these bumps is red. Although pus is often a sign of infection, there is no evidence that infection plays any role in pustular psoriasis.
Pustular psoriasis. Note the clearly defined, raised bumps on the skin that are filled with pus (pustules). The skin under and around these bumps is red.
Pustular psoriasis may precede, accompany, or follow the standard form of plaque-type psoriasis.
Pustular psoriasis is classified into one of several types, depending on symptoms. Symptoms may be sudden and severe (acute), long term (chronic), or somewhere in between (subacute). Widespread pustular psoriasis (von Zumbusch type) affects large areas of skin and can produce a systemic febrile illness. 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 involvement. Pustules may be localized to the palms and soles (palmoplantar pustulosis) or to the fingertips and nails (acrodermatitis continua of Hallopeau). Less common is the juvenile, or infantile type, which occurs in children. Pustular psoriasis in pregnancy (impetigo herpetiformis) is occasionally life-threatening.
Pustular psoriasis is not a common disease. Far more common forms of psoriasis are plaque psoriasis and guttate psoriasis, which account for over 90% of psoriasis. Pustular psoriasis affects all races. In adults, it affects men and women equally. In children, it affects boys somewhat more often than girls. The average age of people with pustular psoriasis is 50 years. Children 2-10 years of age can be affected by the disease, but this is rare.