Pustulosis acuta generalisata (PAG) is a rare poststreptococcal disease of the skin, which has been reported in children and adults after streptococcal throat infection. Herein, we report on the case of a 47-year-old woman with typical clinical and histologic findings of PAG emerging after a pharyngeal infection in whom inflammatory joint-involvement developed. The patient was found to be HLA-A2 and HLA-B35 positive. Whereas HLA-B35 might be associated with pustular skin diseases, HLA-A2 is a risk factor for the development of rheumatoid arthritis.