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Pustular Psoriasis

http://www.webmd.com/skin-problems-and-treatments/psoriasis/pustular-psoriasis [email protected]

Pustular psoriasis is an uncommon form of psoriasis. People with pustular psoriasis have clearly defined, raised bumps on the skin filled with pus (pustules). The skin under and around these bumps is red. Large portions of the skin may redden.

Causes:

  • Taking systemic steroids (steroid medications given by mouth or by injection) and then discontinuing them
  • Various drugs, including the following:
    • Salicylates, compounds made from salicylic acid, are often used to treat pain and fever.
    • Iodine, a topical antiseptic
    • Lithium or trazodone, antidepressants
    • Phenylbutazone or oxyphenbutazone, nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Penicillin, an antibiotic
    • Hydroxychloroquine, a drug for malaria
    • Calcipotriol, a type of vitamin-D
    • Interferon alfa and recombinant interferon-beta injections, chemotherapy drugs
  • Irritating topical solutions (creams or ointments applied to the skin), including tar, anthralin, steroids under occlusion, and zinc pyrithione in shampoo
  • Infections
  • Pregnancy
  • Sunlight or phototherapy
  • Cholestatic jaundice(yellowish staining of the skin and eyes, caused by bile)
  • Hypocalcemia (abnormally low levels of calcium in the blood)

 In many people, the trigger is never identified.

Symptoms:

Appears in the anal and genital area. Also, on the bends and fold of skin, can appear on face but is unusal. Can appear on tongue which makes it difficult to swallow. Can also occur under nails which makes nails fall off.

  • Fiery red and tender ski. 
  • Headaches 
  • fever
  • Chills 
  • joint pain 
  • A feeling of general discomfort or uneasiness
  • Decreased appetite
  • Nausea 
  • Within hours, you may see clusters of pustules.

Exams and Tests

Your doctor may perform blood tests, including the following:

  • A complete blood count (CBC)
  • A urine sample 
  • A small sample of a pustule’s contents to perform a culture.

Treatment:

Topical drugs

  • Vitamin D 
  • Coal tar 
  • Corticosteroids 
  • Tree bark extract
  • Topical retinoid 

Systemic medications (those that circulate throughout the body)

  • Psoralens 
  • Etanercept
  • Methortrexate
  • Cyclosporine 

Prevention

  • avoid excessive sun exposure
  • use a mild soap or cleanser
  • avoid harsh scrubbing 
  • avoid unnecessary trauma to the skin 
  • use a moisturizer
  • avoid triggers, such as stress, excessive alcohol consumption, and smoking

Complications of psoriasis

  • Bacterial skin infections, hair loss, and nail loss
  • Hypoalbuminemia (abnormally low amounts of albumin in the blood) due to loss of blood protein into tissues
  • Hypocalcemia (abnormally low levels of calcium in the blood)
  • Renal tubular necrosis from oligemia (blood deficiency in the body)
  • Liver damage from blood deficiency in the body and general toxicity
  • Malabsorption (in which your gastrointestinal tract doesn’t absorb nutrients sufficiently) and malnutrition

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