Presentation
In children, generalized pustular psoriasis is even more uncommon and may present as a severe and potentially life-threatening disorder. [ncbi.nlm.nih.gov]
Entire Body System
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Fever
She presented with recurrent annular and geographic scaly erythema with a few pustules on the neck, precordium and axilla, but no fever. [ncbi.nlm.nih.gov]
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Chills
M.S. is a 67-year-old African American woman with a history of rheumatoid arthritis and psoriatic arthritis who presented to the emergency room with complaint of new-onset rash, chills, and fatigue after she started taking ramipril (5 mg orally every [ncbi.nlm.nih.gov]
After admission, the patient spiked a temperature of 102 F with chills, the entire workup for which was negative, including blood cultures, chest x-ray, and urine analysis. She underwent skin biopsy to find the cause of her rash. [journals.lww.com]
[ncbi.nlm.nih.gov] Chills M.S. is a 67-year-old African American woman with a history of rheumatoid arthritis and psoriatic arthritis who presented to the emergency room with complaint of new-onset rash, chills, and fatigue after she started taking ramipril [symptoma.com]
Systemic symptoms Flares of generalised pustular psoriasis often result in: Fever Chills A headache Rapid pulse rate Loss of appetite Nausea Muscle weakness Remission occurs within days or weeks and the skin reverts to its previous state or erythroderma [dermnetnz.org]
Von Zumbusch pustular psoriasis is associated with fever, chills, severe itching, dehydration, a rapid pulse rate, exhaustion, anemia, weight loss and muscle weakness. [healthjade.com]
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Malaise
[…] psoriasis Triggers include: Withdrawal of systemic corticosteroids or very potent topical steroids in a patient with known psoriasis Drugs such as lithium and salicylates Pregnancy History Patients often have systemic upset with sore skin, fever and malaise [pcds.org.uk]
[healthjade.com] Malaise […] sore skin, fever and malaise [pcds.org.uk] Sore throat, cough, malaise and "feverishness" were present since a week. [symptoma.com]
Sore throat, cough, malaise and "feverishness" were present since a week. There was no past or family history of any dermatoses including psoriasis. She had tachycardia (110/min) and pyrexia (101 F). Nails and mucosae were uninvolved. [ijpd.in]
The Zumbusch type was characterized by widespread fiery erythema, sheeted pustulation and scarlatiniform peeling, accompanied by malaise, fever and often leucocytosis. [onlinelibrary.wiley.com]
Generalized pustular psoriasis (GPP) is a chronic, systemic inflammatory disease accompanied by high fever and general malaise. Diffuse erythema and swelling of the extremities occur, with multiple sterile pustules all over the body in GPP patients. [pubfacts.com]
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Fatigue
M.S. is a 67-year-old African American woman with a history of rheumatoid arthritis and psoriatic arthritis who presented to the emergency room with complaint of new-onset rash, chills, and fatigue after she started taking ramipril (5 mg orally every [ncbi.nlm.nih.gov]
Frame: Week 2 ] Proportion of patients with Generalized Pustular Psoriasis Physician Global Assessment total score of 0 (clear) or 1 (almost clear) at Week 2 [ Time Frame: Week 2 ] Change from baseline in Functional Assessment of Chronic Illness Therapy-Fatigue [clinicaltrials.gov]
[pubfacts.com] Fatigue M.S. is a 67-year-old African American woman with a history of rheumatoid arthritis and psoriatic arthritis who presented to the emergency room with complaint of new-onset rash, chills, and fatigue after she started taking ramipril [symptoma.com]
The skin problems can be accompanied by fever, extreme tiredness (fatigue), muscle weakness, an increased number of white blood cells, and other signs of inflammation throughout the body (systemic inflammation). [healthjade.com]
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Anorexia
[healthjade.com] Anorexia [e-ijd.org] Anorexia Patients are usually systemically unwell with symptoms including headache, fever, chills, arthralgia, malaise, anorexia and nausea. [symptoma.com]
Patients are usually systemically unwell with symptoms including headache, fever, chills, arthralgia, malaise, anorexia and nausea. On examination, there is maybe a fast respiratory rate, tachycardia and pyrexia suggesting a toxic state. [patient.info]
Patients appear systemically ill, with high-grade fever, chills, malaise, and anorexia.8,11,12 Erythroderma may occur. [dovepress.com]
Onset of an acute generalized pustular psoriasis is characterized by red and tender skin with systemic symptoms like fever, anorexia and nausea. Within hours, innumerable pustules appear with an erythematous background. [intechopen.com]
Patients may have a preceding history of psoriasis, although this is not a requirement. [11] Constitutional signs and symptoms include headache, fever, chills, arthralgia, malaise, anorexia, and nausea. [emedicine.medscape.com]
Gastrointestinal
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Nausea
[emedicine.medscape.com] Gastrointestinal Nausea [dovepress.com] Gastrointestinal Nausea Systemic symptoms Flares of generalised pustular psoriasis often result in: Fever Chills A headache Rapid pulse rate Loss of appetite Nausea Muscle weakness Remission [symptoma.com]
Systemic symptoms Flares of generalised pustular psoriasis often result in: Fever Chills A headache Rapid pulse rate Loss of appetite Nausea Muscle weakness Remission occurs within days or weeks and the skin reverts to its previous state or erythroderma [dermnetnz.org]
This skin eruption is often accompanied by a fever, muscle aches, nausea, and an elevated white blood cell count. Annular pustular psoriasis (APP), a rare form of GPP, is the most common type seen during childhood. [en.wikipedia.org]
Treatment with cyclosporine, prednisolone, etanercept, anakinra and ustekinumab followed with unsatisfactory result and weekly to monthly exacerbations in addition to intolerable side-effects, such as nausea from cyclosporine despite anti-emetics. [medicaljournals.se]
Generalized pustular psoriasis can cause: Fever Chills Nausea Fast heart rate Muscle weakness Triggers include: Topical medicine (ointments you put on your skin) or systemic medicine (drugs that treat your whole body), especially steroids Suddenly stopping [psoriasis-help.co.uk]
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Loss of Appetite
[…] of Appetite [patient.info] Loss of Appetite Systemic symptoms Flares of generalised pustular psoriasis often result in: Fever Chills A headache Rapid pulse rate Loss of appetite Nausea Muscle weakness Remission occurs within days or weeks and the skin [symptoma.com]
Systemic symptoms Flares of generalised pustular psoriasis often result in: Fever Chills A headache Rapid pulse rate Loss of appetite Nausea Muscle weakness Remission occurs within days or weeks and the skin reverts to its previous state or erythroderma [dermnetnz.org]
Loss of appetite. Muscle weakness. Pustular psoriasis: This type of psoriasis causes pus-filled bumps that usually appear on the foot or hand. [pariserderm.com]
This may be accompanied by chills, a fever, headache, rapid pulse rate, nausea, muscle weakness, or loss of appetite. Two to three millimeter pustules filled with non- infectious pus appear, concentrated on the flexures and genital areas. [psoriasisrx.com]
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Dysphagia
[malacards.org] Dysphagia [delveinsight.com] Dysphagia Pustules may occur on the tongue and under the nails, causing dysphagia and loss of nails respectively. [symptoma.com]
Pustules may occur on the tongue and under the nails, causing dysphagia and loss of nails respectively. Patients are usually systemically unwell with symptoms including headache, fever, chills, arthralgia, malaise, anorexia and nausea. [patient.info]
Pustules can appear on the tongue and develop subungually, resulting in dysphagia and nail shedding, respectively. [20] Pustules coalesce within 1 day to form lakes of pus that dry and desquamate in sheets, leaving behind a smooth, erythematous surface [emedicine.medscape.com]
Jaw & Teeth
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Fissured Tongue
Other clinical features in acute GPP flares included uveitis, conjunctivitis, iritis, leg swelling, geographic or fissured tongue, and cheilitis [18,19,22]. [tandfonline.com]
Associated cutaneous symptoms may include pain, burning, and pruritus.8 Associated mucosal findings include a geographic or fissured tongue, cheilitis, and ocular involvement (eg, conjunctivitis, uveitis, iritis).3,13 Additional extracutaneous findings [dovepress.com]
tongue (FT).4,8 Cases involving lingual psoriasis are exceptionally scant, with 100 publications available,6,9 and presentation and subsequent management of lingual pustular psoriasis have not yet been reported. [emjreviews.com]
The oropharyngeal mucosa may be hyperemic, and a geographic tongue or fissured tongue may be appreciated. [emedicine.medscape.com]
Mucosal manifestations may include geographic tongue, fissured tongue and ocular symptoms such as conjunctivitis. Patients may also exhibit cheilitis as the lips may become red, scaly and superficially ulcerated. [onlinelibrary.wiley.com]
Cardiovascular
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Tachycardia
She had tachycardia (110/min) and pyrexia (101 F). Nails and mucosae were uninvolved. [symptoma.com]
She had tachycardia (110/min) and pyrexia (101 F). Nails and mucosae were uninvolved. Erythrocyte sedimentation rate (ESR) was 41 mm and leukocyte count, 12,000 cells/cmm. Suspecting drug rash, oral prednisolone (40 mg) was administered. [ijpd.in]
On examination, there is maybe a fast respiratory rate, tachycardia and pyrexia suggesting a toxic state. The tongue is dry and cracked. [patient.info]
The extreme peeling of skin can lead to rapid dehydration, tachycardia (rapid heart rate), and an increased risk of infection. If not properly treated Von Zumbusch psoriasis can become life-threatening. [verywellhealth.com]
Eyes
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Corneal Infiltrate
Multiple focal sterile corneal infiltrates were seen. Haematological investigations and a skin biopsy were done as the consulting dermatologist suspected acute generalized pustular psoriasis. [ncbi.nlm.nih.gov]
Skin
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Erythema
We experienced a 2-year-old female with erythema on her neck and axilla starting at 3 months of age. She presented with recurrent annular and geographic scaly erythema with a few pustules on the neck, precordium and axilla, but no fever. [ncbi.nlm.nih.gov]
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Blister
Pustular psoriasis is characterized by white pustules (blisters of noninfectious pus) surrounded by red skin 1). The pus consists of white blood cells. [healthjade.com]
While psoriasis is a commonly treated dermatologic disorder, certain skin patches have been known to cover the body with pus-filled blisters rather than plaques – affecting approximately 3% of patients. [mdmag.com]
It usually occurs with the first few small rashes, and then within a few hours, continuous pus can also form large blisters. These blisters eventually become brown and crusty. After they are peeled, the skin may appear shiny or crusted. [onlymyhealth.com]
Within a few hours, the telltale large blisters of noninfectious pus form. Eventually, these blisters turn brown and crusty. After they peel off, skin can appear shiny or scaly. Pustular psoriasis is not a typical skin rash. [healthline.com]
Symptoms often begin with skin reddening and tenderness, but within a few hours, blisters full of noninfectious pus begin to form. Over time, these blisters will become brown or crusty. [zelskin.com]
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Skin Rash
Deficiency of interleukin-36 (IL-36) receptor antagonist (DITRA; OMIM 614204) is a rare autoinflammatory disorder characterized by periodic fever associated with a generalized erythematous and pustular skin rash. [ncbi.nlm.nih.gov]
The advantages of topical formulations include the direct application of drugs onto skin rashes, rapid onset, convenient use, and few systemic adverse reactions. [journals.lww.com]
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Skin Pustule
BACKGROUND: Generalized pustular psoriasis (GPP) is a rare, debilitating, and often life-threatening inflammatory disease characterized by episodic infiltration of neutrophils into the skin, pustule development, and systemic inflammation, which can manifest [ncbi.nlm.nih.gov]
[…] into the skin, pustule development, and systemic [symptoma.com] Moreover, skin pustules were observed to be completely cleared in both patients by day 8 and through day 113. [symptoma.com]
Moreover, skin pustules were observed to be completely cleared in both patients by day 8 and through day 113. Additional clinical data from the GALLOP study are expected to be announced in the second half of 2020. [empr.com]
Von Zumbusch pustular psoriasis Von Zumbusch psoriasis (acute generalized pustular psoriasis) begins with painful areas of red skin. Pustules form within hours and dry up in a day or two. [healthline.com]
The most common places these pustules appear are the anal and genital areas and the skin folds in the skin. Pustules may appear on the face, but this is unusual. Pustules can appear on the tongue, which may make it difficult to swallow. [emedicinehealth.com]
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Skin Plaque
[emedicinehealth.com] Skin Plaque [emedicinehealth.com] Skin Plaque Plaque psoriasis, the most common form of psoriasis, is characterized by red, scaly patches of skin (plaques) on parts of the body. [symptoma.com]
Plaque psoriasis, the most common form of psoriasis, is characterized by red, scaly patches of skin (plaques) on parts of the body. [healthjade.com]
PV, the most common form of psoriasis, is characterized by red, scaly patches of skin (plaques) on parts of the body. GPP is the rarest form of psoriasis. [ghr.nlm.nih.gov]
PV, the most common form of psoriasis, is characterized by red, scaly patches of skin (plaques) on parts of the body. 2. Frequency GPP is the rarest form of psoriasis. [encyclopedia.pub]
The pustules form as studs on top of red skin plaques, and then turn brown, peel, and crust over. Acropustulosis. This subtype causes the formation of skin lesions on fingertips. The lesions sometimes occur on the toes as well. [everydayhealth.com]
Musculoskeletal
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Arthritis
M.S. is a 67-year-old African American woman with a history of rheumatoid arthritis and psoriatic arthritis who presented to the emergency room with complaint of new-onset rash, chills, and fatigue after she started taking ramipril (5 mg orally every [ncbi.nlm.nih.gov]
Case report : A 50‐year‐old woman had suffered from severe pustular psoriasis for 10 years and psoriatic arthritis for 8 years and received treatment with adalimumab, in monotherapy, 40 mg subcutaneously once a week for 72 weeks. [doi.org]
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Arthralgia
Nasopharyngitis, urticaria, diabetes mellitus and arthralgia were the frequent adverse events reported. The data from this study shows that secukinumab can become one of the potent treatment options for GPP. 2016 Japanese Dermatological Association. [ncbi.nlm.nih.gov]
[ncbi.nlm.nih.gov] [ncbi.nlm.nih.gov] Musculoskeletal Arthralgia Nasopharyngitis, urticaria, diabetes mellitus and arthralgia were the frequent adverse events reported. [symptoma.com]
[…] suffered from psoriasis vulgaris (pso GPP) or may not have (pso GPP) [Table 2]. [4] Beylot et al. [6] classified GPP clinically into acute, annular and mixed types; only some of the patients of the acute type being ill with intermittent fever, malaise, and arthralgia [ijpd.in]
Click here for example images of pustular psoriasis Subtypes of generalized pustular psoriasis: Generalized: von Zumbusch subtype: Diffuse generalized pustular eruption with associated systemic symptoms (fevers, arthralgias, etc.) [gpnotebook.com]
Patients are usually systemically unwell with symptoms including headache, fever, chills, arthralgia, malaise, anorexia and nausea. On examination, there is maybe a fast respiratory rate, tachycardia and pyrexia suggesting a toxic state. [patient.info]
Neurologic
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Headache
[onlinelibrary.wiley.com] Neurologic Headache [onlinelibrary.wiley.com] Neurologic Headache Systemic symptoms Flares of generalised pustular psoriasis often result in: Fever Chills A headache Rapid pulse rate Loss of appetite Nausea Muscle weakness Remission [symptoma.com]
Systemic symptoms Flares of generalised pustular psoriasis often result in: Fever Chills A headache Rapid pulse rate Loss of appetite Nausea Muscle weakness Remission occurs within days or weeks and the skin reverts to its previous state or erythroderma [dermnetnz.org]
In the multiple ascending dose cohorts, the most frequent treatment-emerging adverse events observed were headache in 7 of 18 (39%) subjects dosed with ANB019 versus 1 of 6 (17%) subjects dosed with placebo. [anaptysbio.com]
Patients are usually systemically unwell with symptoms including headache, fever, chills, arthralgia, malaise, anorexia and nausea. On examination, there is maybe a fast respiratory rate, tachycardia and pyrexia suggesting a toxic state. [patient.info]
Workup
After admission, the patient spiked a temperature of 102 degrees F with chills, the entire workup for which was negative, including blood cultures, chest x-ray, and urine analysis. She underwent skin biopsy to find the cause of her rash. [ncbi.nlm.nih.gov]
After admission, the patient spiked a temperature of 102 F with chills, the entire workup for which was negative, including blood cultures, chest x-ray, and urine analysis. She underwent skin biopsy to find the cause of her rash. [journals.lww.com]
[patient.info] Workup After admission, the patient spiked a temperature of 102 degrees F with chills, the entire workup for which was negative, including blood cultures, chest x-ray, and urine analysis. [symptoma.com]
Our rationale during the initial workup and the subsequently encountered diagnostic challenge are presented in Figure 6. [cureus.com]
The laboratory workup performed on her first visit showed hematuria, proteinuria, and mild renal dysfunction (Table 1). Fig. 1 Clinical course. [bmcnephrol.biomedcentral.com]
Treatment
To demonstrate the efficacy and tolerability of adalimumab in the treatment of GPP. [ncbi.nlm.nih.gov]
Aim : To demonstrate the efficacy and tolerability of adalimumab in the treatment of GPP. [doi.org]
Prognosis
The data included patient demographics, associated symptoms, aggravating factors, patterns of relapse and prognosis. Thirty-three patients with GPP were included in our study, with a mean age of 45.6 years and a male : female ratio of 1:1.2. [ncbi.nlm.nih.gov]
G.P.P. developing from acral pustulosis (acrodermatitis continua) has the worst prognosis and is likely to prove fatal. [doi.org]
Prognosis Older patients with the von Zumbusch-type variant have a poorer prognosis. Children tend to have a good prognosis unless there is secondary infection. [patient.info]
Etiology
Epidemiology, etiology, diagnosis, and treatment options are discussed in this paper. [ncbi.nlm.nih.gov]
Various investigations provided no real clue to the etiology, but there was a relatively high incidence of seborrheic dermatitis. In contrast to adult patients, in only 12% was there a prior history of psoriasis vulgaris. [doi.org]
Epidemiology
Epidemiology, etiology, diagnosis, and treatment options are discussed in this paper. [ncbi.nlm.nih.gov]
Murphy, The epidemiology of childhood psoriasis: a scoping review, British Journal of Dermatology, 174, 6, (1242-1257), (2016). [doi.org]
Primary Outcome Measures : prevalence of Palmoplantar pustulosis [ Time Frame: From 2012 to 2016 in the Urban Employee Basic Medical Insurance (UEBMI) data of China ] Epidemiological characteristics of diseases: Mainly referring to indicators that could [clinicaltrials.gov]
[doi.org] Epidemiology Epidemiology, etiology, diagnosis, and treatment options are discussed in this paper. [symptoma.com]
Generalized Pustular Psoriasis (GPP) - Epidemiology The GPP epidemiology division provide the insights about historical and current patient pool and forecasted trend for every 7 major countries. [delveinsight.com]
Pathophysiology
However, recent clinical, histological, and genetic evidence has provided new insights into the pathophysiology of pustular psoriasis, allowing for new therapeutic targets with novel treatments. [gotoper.com]
[delveinsight.com] Pathophysiology However, recent clinical, histological, and genetic evidence has provided new insights into the pathophysiology of pustular psoriasis, allowing for new therapeutic targets with novel treatments. [symptoma.com]
References Iizuka H, Takahashi H, Ishida-Yamamoto A (2003) Pathophysiology of generalized pustular psoriasis. Arch Dermatol Res 295: S55-59. Tavarela Veloso F (2004) Review article: skin complications associated with inflammatory bowel disease. [omicsonline.org]
Pustular psoriasis: pathophysiology and current treatment perspectives. Psoriasis (Auckl). 2016;6:131-144. Bachelez H, Choon S, Marrakchi S, et al. [exchangecme.com]
Pustular psoriasis: pathophysiology and current treatment perspectives. Psoriasis (Auckl). 2016;6:131-44. doi:10.2147/PTT.S98954 Miller, A.; Holland, T.; and Cohen, D. Treatment of Acrodermatitis continua of Hallopeau with Ixekizumab. [verywellhealth.com]
Prevention
Monitoring CD4 T lymphocyte count, preventing and correcting CD4 lymphocytopenia are important in the treatment course of juvenile GPP. [ncbi.nlm.nih.gov]
Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment Adherence United States Preventive [doi.org]
The aim is to prevent further fluid loss, stabilise body temperature and restore electrolyte imbalance. Specialist care is essential. Affected areas are treated with bland topical compresses using emollients and low potency topical steroid creams. [dermnetnz.org]
[verywellhealth.com] Prevention Monitoring CD4 T lymphocyte count, preventing and correcting CD4 lymphocytopenia are important in the treatment course of juvenile GPP. [symptoma.com]