Generalized Pustular Psoriasis, Acute Generalized Exanthematous Pustulosis, and Other Pustular Reactions: A Clinical Review

Elisabeth Gössinger; Roni Dodiuk-Gad; Beda Mühleisen; Hazel H Oon; Choon Chiat Oh; Julia-Tatjana Maul; Alexander A Navarini

doi:10.1016/j.det.2024.01.001

Generalized Pustular Psoriasis, Acute Generalized Exanthematous Pustulosis, and Other Pustular Reactions: A Clinical Review

Dermatol Clin. 2024 Apr;42(2):317-328. doi: 10.1016/j.det.2024.01.001.

Authors

Elisabeth Gössinger¹, Roni Dodiuk-Gad², Beda Mühleisen¹, Hazel H Oon³, Choon Chiat Oh⁴, Julia-Tatjana Maul⁵, Alexander A Navarini⁶

Affiliations

¹ Department of Dermatology, University Hospital of Basel, Burgfelderstrasse 101, Basel 4055, Switzerland.
² Department of Dermatology, Emek Medical Center, Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, 3525433 Israel; Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario M5S 1A1, Canada.
³ Department of Dermatology, Emek Medical Center, Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, 3525433 Israel; National Skin Centre and Skin Research Institute of Singapore (SRIS), 1 Mandalay Road, Singapore 308205, Singapore.
⁴ Department of Dermatology, Singapore General Hospital, Singapore, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
⁵ Department of Dermatology, University Hospital of Zurich and Faculty of Medicine, Zurich 8091/8006, Switzerland.
⁶ Department of Dermatology, University Hospital of Basel, Burgfelderstrasse 101, Basel 4055, Switzerland; Department of Biomedical Research, University of Basel, Allschwil 4123, Switzerland; Department of Biomedical Engineering, University of Basel, Allschwil 4123, Switzerland; Department of Clinical Research, University of Basel, Allschwil 4123, Switzerland. Electronic address: alexander.navarini@usb.ch.

PMID: 38423690
DOI: 10.1016/j.det.2024.01.001

Abstract

Generalized pustular rashes have various etiologies and can be challenging to diagnose and manage at first presentation. The authors provide an in-depth analysis of common pustular skin eruptions including generalized pustular psoriasis (GPP) and acute generalized exanthematous pustulosis, focusing on their pathophysiology, triggers, clinical presentation, diagnostic challenges, and management strategies. The article also highlights recent advances in genetic research and biologic therapies for GPP and the future directions in personalized medicine and prevention strategies.

Keywords: Acute generalized exanthematous pustulosis; Biologic therapies; Drug-induced reactions; Generalized pustular psoriasis; Genetic mutations; IL-36 pathway; Pustular skin eruptions.

Publication types

Review

MeSH terms

Acute Disease
Acute Generalized Exanthematous Pustulosis* / diagnosis
Acute Generalized Exanthematous Pustulosis* / etiology
Acute Generalized Exanthematous Pustulosis* / therapy
Chronic Disease
Humans
Psoriasis* / diagnosis
Psoriasis* / therapy
Skin
Skin Diseases, Vesiculobullous* / chemically induced
Skin Diseases, Vesiculobullous* / diagnosis
Skin Diseases, Vesiculobullous* / therapy