Pustular psoriasis is an uncommon form of psoriasis mainly found in adults, according to the National Psoriasis Foundation. Non-infectious, pus-filled sores form on either localized portions of skin or cover large areas of the body. As pustular psoriasis can cause life threatening complications, the New Zealand Dermatological Society indicates that hospitalization is usually recommended.
Symptoms
At the beginning phase of this condition, the skin becomes red and tender. Within hours, MayoClinic.com indicates that pus-filled blisters develop on these areas. While breakouts may emerge anywhere on the body, the New Zealand Dermatological Society says they often occur on the hands, feet and in the genital areas. Pustular psoriasis manifests in cycles, with pustules that burst, forming large pools of pus. The pus dries and peels, forming a smooth surface that appears glazed. New crops of pustules may form on top of these areas. This cycle repeats over a period of a few days to weeks. The New Zealand Dermatological Society lists symptoms that may emerge in conjunction with the skin condition, including fever, chills, headache, rapid pulse rate, loss of appetite, nausea and muscle weakness. Further symptoms, indicated by MayoClinic.com, include severe itching and fatigue.
Causes
Some individuals who develop pustular psoriasis have a history of chronic plaque psoriasis, the most common form of psoriasis, according to the New Zealand Dermatological Society. For many of these individuals with a history of psoriasis, no identifiable cause may be determined. The National Psoriasis Foundation identifies a number of causes, including reaction to internal medication, irritating topical agents, too much exposure to ultraviolet lights, pregnancy, infections, stress, withdrawal from systemic medication or certain steroids.
Types
Three forms of pustular psoriasis exist. Von Zumbusch type develops quickly and affects a large area of the body, the National Psoriasis Foundation says, with a cycle similar to what was described above. If this develops in children, it may consist of the first indication of psoriasis. Von Zumbusch can be a lethal form of this condition, necessitating immediate hospitalization for treatment. In palmoplantar pustulosis, the National Psoriasis Foundation indicates that pustules commonly develop on the palms of hands, soles of feet, at the base of the thumb and sides of the heels. Pustules develop in a "studded pattern overlying red plaques of skin, then turn brown, peel and become crusted," according to the National Psoriasis Foundation. It follows a cyclical pattern, with new crops being followed by low activity. The National Psoriasis Foundation indicates that acropustulosis is a rare form of this condition forming on the ends of fingers and toes. Lesions emerge after a skin injury or infection. The condition is usually painful, disabling and may deform the nails or even bones in severe cases.
Complications
The New Zealand Dermatological Society says pustular psoriasis causes various complications, the most severe of which is death caused by cardiorespiratory failure during the outbreak phase of the condition. Elderly individuals are at greatest risk for this. Other complications include bacterial infection, low amounts of protein and electrolyte imbalance, kidney and liver impairment, problems absorbing nutrients and therapeutic drugs, and arthritis. Other complications associated with psoriasis according to MayoClinic.com include depression, anxiety, stress and low self-esteem.
Treatment
Hospitalization is generally required with this condition enabling doctors to stabilize an individual. Doctors will work to prevent additional loss of fluids, restore proper body temperature and balance electrolytes, according to the New Zealand Dermatological Society. Further antibiotics may be given for infections, and other medications may be prescribed in severe cases or if the individual is exhausted from repeated outbreaks. Phototherapy may be used, which involves exposing the individual's skin to bright light in controlled doses from natural or artificial sources.
