Generalized Pustular Psoriasis: A 29-Year Study of 63 Patients

In a 29-year study of 63 patients with generalized pustular psoriasis (GPP), researchers identified four subgroups based on onset and morphologic patterns: acute (von Zumbusch), subacute annular, chronic (acral), and mixed. The average age at onset was 50 years, with an equal gender distribution. Flares were often triggered by infections, and about 25% of patients experienced complications, primarily superinfections. The average hospital stay was 30 days, with longer durations linked to hypocalcemia, female sex, and a history of psoriasis vulgaris or pustular psoriasis. While topical therapy was helpful, systemic medications were frequently required. Treatments like coal tar, ultraviolet light, and PUVA were effective but had to be used with caution due to the risk of exacerbating the disease.