Pustular psoriasis:

Precipitating factors: Pustulation precipitated by:

• Irritant effect of topical therapy
• Withdrawal of topical or systemic steroids

Clinical features: Pustulation can be:

• Localized: as seen in palmoplantar psoriasis
• Generalized: as seen in von Zumbusch’s pustular psoriasis which is:
  • A serious condition accompanied by constitutional symptoms (high fever, chills, tachypnea).

Characterized by generalized fiery red erythema followed by appearance of tiny waves of superficial pustules (often can be easily wiped off), which become confluent to form circinate lesions and lakes of pus. Appearance of new pustules as the old ones are crusting.

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