This type of psoriasis is quite uncommon. Those who have pustular psoriasis have raised bumps on their skin. These bumps are filled with pus. The skin both around and under these bumps is definitely red. Sometimes very large portions of one’s skin may redden.
The changes to one’s skin before, after, or during an episode of pustular psoriasis may actually be quite similar to those of regular psoriasis. Pustular psoriasis is usually classified into one of several types and is dependent on the symptoms. They are as follows:
- Acute – Sudden and severe
- Chronic – Long term
- Subacute – Somewhere in between
The generalized type will affect your entire body, and with more than just skin problems. One with acute symptoms such as fever, and a toxic tissue reaction, is called the von Zumbusch type. The ring like type, often referred to as annular or circinate, is usually subacute or chronic. People who have this type usually have no symptoms aside from the skin ones. Pustules may also be contained to the palms and soles of the feet. This is called palmoplantar pustulosis. The least common type is the one which occurs in children.
Pustular psoriasis is pretty rare. It will, however, not discriminate and affect all different races. In adults, it affects men and women fairly equally. In children, it affects boys a tad more often than girls. The average age of someone with pustular psoriasis is about 50 years old. Children aged 2-10 can be affected, but this is not common at all.
Although doctor’s often can’t find the exact culprit, pustular psoriasis has been linked to the following:
- Taking systemic steroids and then discontinuation
- Numerous different drugs, including the following:
- Salicylates, Iodine, Lithium or trazodone, oxyphenbutazone, nonsteroidal anti-inflammatory drugs (NSAIDs), Penicillin, Hydroxychloroquine, Calcipotriol, Interferon alfa and recombinant interferon-beta injections, irritating topical solutions including tar, anthralin, steroids under occlusion, and zinc pyrithione in shampoo.
- General Infections
- Too Much Sunlight or phototherapy
- Cholestatic jaundice
- Hypocalcemia which is abnormally low levels of calcium in the blood
In many people though, the exact trigger is simple never discovered.
Pustular Psoriasis Symptoms, Tests, and Treatment
With the general type of pustular psoriasis, a patient’s skin is often quite red and very tender. They often have numerous different symptoms including headache, chills, fever, general discomfort or uneasiness, no appetite, and nausea as well. Usually within a few hours, a person will notice clusters of pustules forming on the skin. They most often appear in the anal and genital area, as well as in the bends or folds of the skin. If they crop up on the tongue, they can make it very hard to swallow. Sometimes they can occur under the nails. If so, it will usually cause the nails to fall off. All and all quite a painful experience.
After one sees improvement with the pustules, the other symptoms will begin to recede and eventually disappear. Some people continue to see bright red skin though and retain the symptoms of nonpustular psoriasis.
Young kids are usually the ones who experience the ring-shaped type of psoriasis. It’s usually subacute or chronic. The symptoms are often much less severe too. Ring-shaped plaques (elevated areas) will pop up and often become recurrent. Pustules may appear at the edges of these rings. You’ll usually see these mostly on the trunk of the child, but they will also find their way to legs and arms. The edges tend to expand, and the center heals up. Usually most other symptoms are quite mild if even present. The juvenile type of pustular psoriasis is mild. It almost always goes away on its own. Pustular psoriasis of the palms and soles is chronic. It’s associated with joint or bone inflammation. The palms and soles usually get quite red and have white or yellow pustules on them.
If you develop a rash of raised, bumps on your skin that are pus-filled, you should seek some medical care. This is especially true if you have symptoms like a headache, chills, fever, joint pains, decreased appetite, etc. If you have sores of any type in your mouth or throat that make it difficult to breathe or swallow, then visit your doctor immediately.
Once you see a doctor, he or she may perform a few tests including the following: full and complete blood count, small urine sample, and a culture of the pus inside a pustule.
People with the generalized form of pustular psoriasis usually get admitted to the hospital at some point. It’s important to ensure they have enough fluids in their system and that they get lots of rest. Doctor’s don’t want them to lose too much heat or have much if any strain on the heart. Rest is very important.
The basic types of treatments for psoriasis are as follows:
- Topical Therapy – Drugs are Applied Directly to the Skin
- Phototherapy – Ultraviolet light reduces inflammation, Slows Down Cell Production
- Systemic Therapy – Drugs are Taken into the Body by Mouth or Injection
All of these treatments can be used alone or in conjunction with each other. Of course the basic goal is reduce the patient’s symptoms and prevent major complications. Drugs that are applied directly to the skin are the first step in most treatment plans. The main topical treatments are corticosteroids, coal tar, vitamin D-3 derivatives, anthralin, or retinoids.