Elderly-onset (> 60 years of age) atopic dermatitis and psoriasis have been reported to present special clinical phenotypes; however, the study of elderly-onset generalized pustular psoriasis (GPP) has been limited, mainly due to its rarity. Previous studies have shown that the mean age of GPP onset is around 40 years, and onset at > 60 years of age is extremely rare. We report a case series of seven patients with elderly-onset GPP. The clinical features of the seven patients were assessed, and all seven patient were analysed for presence of the c.115+6T>C mutation in the gene encoding for interleukin-36 receptor antagonist (IL36RN). These patients had an atypical clinical course and a lower frequency of the IL36RN c.115+6T>C mutation. IL36RN mutations may have a significant, dose-dependent effect on the onset age of GPP.
© 2022 British Association of Dermatologists.