Pustular psoriasis is a rare form of skin disease, which is characterized by rash on feet and hands. Over the past few years pustular psoriasis has become increasingly common. Many dermatologists believe that its popularity is connected to aggressive methods of treatment for pustular psoriasis. It may have happened due to pustular psoriasis treatment with cytostatics and corticosteroids. In 60% of cases pustular psoriasis is detected among patients who suffer from “vulgar psoriasis”, and only 40% of this disease cases occur to completely healthy people. Doctors classify pustular psoriasis into three types depending on the clinical course: chronic, subacute and acute pustular psoriasis.
Many people ask: “Is pustular psoriasis contagious?” Doctors describe two forms of pustular psoriasis: generalized and localized pustular psoriasis and none of them is contagious.
Generalized pustular psoriasis
Generalized pustular psoriasis is known in several further forms:
Von Zumbusch pustular psoriasis
Most often this form of generalized psoriasis occurs to perfectly healthy people. It is characterized by sudden appearance of erythema – an inflammation which feels hot when you touch it, causing burning pain. After a while vesicles appear on psoriatic foci, transforming the latter to psoriatic pustules. On certain skin areas they may merge together into large lesion foci. Inflammation can appear anywhere on your body including the scalp. Within a few months after you have noticed the first pustular psoriasis symptoms, pustules may disappear or appear in new areas. This disease is recurrent.
Acrodermatitis persistans also known as Hallopeau’s disease
This dermatosis is characterized by pustular formations of indistinct genesis, which are located on hands (plantar pustular psoriasis) or soles. The disease manifests itself with small inflammations of up to 0.5 cm with clear boundaries. Over time the pustules burst, form erosive surface and become covered with purulent crusts. Hallopeau’s disease is chronic and progressive. Skin atrophy and sclerodermoid changes gradually develop on inflamed areas.
According to the statistics, this form of generalized psoriasis most commonly occurs to women during pregnancy and is much less typical for men and children. The first symptoms appear suddenly. Skin rash appears as painful pustules, which are located mainly in armpits, inguinal region and inner thigh.
Localized pustular psoriasis
Localized pustular psoriasis is divided into:
- Localized form of Hallopeau’s disease also known as acrodermatitis continua. Localized psoriasis pustular is a disease that affects the pubis area. It often accompanies psoriasis vulgaris.
- Barber’s pustulosis also known as pustulosis palmaris et plantaris. Palmoplantar pustular psoriasis is another name for this form of psoriasis. Barber’s pustulosis is chronic, undulating and may also accompany psoriasis vulgaris. Typical rash lesions appear on feet and hands. Subsequently the pustules dry out, forming a dense brown crust. Palmar plantar pustular psoriasis is not dangerous but very unpleasant disease.
- Psoriasis with further postulation. This form is basically the result of external treatment of psoriasis vulgaris. The first symptoms of the disease manifest with appearance of pustules, which are formed at the site of inflammation foci of psoriasis vulgaris.
Pustular psoriasis pictures
Pustular psoriasis treatment
This severe form of psoriasis can be triggered by a variety of factors. Pustular psoriasis causes include infection, stressful situations, hormonal disorders and local or general treatment of psoriasis vulgaris. Pustular psoriasis progresses on the background of the deterioration of general health condition and is accompanied by fever, leukocytosis and raising erythrocyte sedimentation rate. At the same time the patient feels burning and pain in the inflammatory foci. New pustules appear undulatory and form suppurative spots. The emergence of new foci of inflammation is always accompanied by fever.
There is no direct answer to the question “How to treat pustular psoriasis?” Patients who have this diagnosis go to hospital where the doctors set an individual course of treatment. A combination of retinoids, PUVA therapy and photochemotherapy is considered to be the most effective treatment. Pustular psoriasis is quite complicated and durable to cure. It also requires special pustular psoriasis diet.
Psoriasis: exudative form
Exudative psoriasis often occurs to patients with diabetes, as well as people suffering from obesity and hypothyroidism. Typical symptoms are psoriatic lesions of grayish-yellow color with loose scales. Inflammation areas usually itch and burn.
Exudative psoriasis treatment
Any form of psoriasis is incurable, but sometimes it does not manifest itself actively. The disease is undulating; remission period is often followed by a period of exacerbation. Remission can last for quite long. In some cases patients don’t have any obvious symptoms even for several years. However, under the influence of provoking factors psoriatic plaques appear again. Modern treatment methods can significantly reduce typical symptoms and improve patient’s life quality.
Treatment depends on the severity of the disease and its particular form. Sometimes psoriasis progresses so mildly that the person is not even aware of its existence. However, for various reasons (stress, hormonal disorders, the pathogenesis of the immune system, etc.) the disease can develop into a more severe form. In those cases when inflammatory foci cover most of skin surface, the patient has to be hospitalized.
When doctors prescribe treatments they take into account many factors. Among them are individual features and general condition of the patient. As a rule psoriasis treatment consists of complex therapy.