Pustular Psoriasis Guide


Palmoplantar pustular psoriasis affects approximately a quarter of patients with psoriasis. When pustules appear on palms and on feet we deal with palmar pustular psoriasis or plantar pustular psoriasis, depending on the affected area.

This type of the disease causes a lot of pain and suffering for the patients. As long as it is located in the places which are usually covered with footwear, the process of putting on the shoes may be extremely painful. Moreover, it is a reason of huge psychological discomfort and social isolation of the patients.

Pustular Psoriasis

As a form of the skin disease, pustular psoriasis is quite rare. The main symptom of the disease is the rash which usually concentrates on hands and on feet. Unfortunately, the disease tends to become more common nowadays. Many scientists and doctors consider aggressive treatment (this usually means that cytostatics and corticosteroids had been used) one of the causes of the disease increase. Usually, pustular psoriasis affects patients with the diagnosis of psoriasis vulgaris (60 percent of cases of pustular psoriasis). Only 40 percent of the disease occur in people who are absolutely healthy.

Pustular Psoriasis Causes

Scientists believe there are certain factors that usually become pustular psoriasis causes. According to the medical statistics, here are some triggering factors.

  • Certain medications (orally or parenterally administered corticosteroids) and their abrupt withdrawal.
  • Intake of cytotoxic drugs, such as methotrexate.
  • Different medicines can become the reason of transformation (salicylates; antipyretic agents; antidepressants; nonsteroidal anti-inflammatory drugs; antibiotics; penicillin; hydroxychloroquine, an antimalaria drug; injection of alpha and beta recombinant interferons; chemotherapy drugs; sodium thiosulfate; diazolin; anabolic steroids; progesterone; beta-blockers; oral contraceptives).
  • Strong irritating dermatics (tar, anthralin), corticosteroids, zinc pyrithione in shampoos, salicylic ointments.
  • Stressful situations.
  • Infections (both viral and bacterial).
  • Phototherapy and sunlight.
  • Often appears in pregnancy and hormonal dysfunction.
  • Cholestatic jaundice (skin and scleras become yellow because of biliary retention).
  • Hypocalcemia (extremely low levels of calcium in blood).

Pustular Psoriasis Symptoms and Forms

The scientists distinguish two forms of the disease called pustular psoriasis. These forms include generalized pustular psoriasis and localized pustular psoriasis.

Pustular psoriasis pictures

The first one or generalized pustular psoriasis is a severe form of the disease which is often a threat to human life. In this form, the pustules may appear even on patient’s face and tongue in addition to more typical places. It is rarely observed in children. This type, in its turn, is divided into:

Von Zumbusch pustular psoriasis

These types of pustular psoriasis symptoms are usually observed in healthy people. When the disease suddenly comes, people experience erythema. This is the inflammation which feels hot when you touch it. The inflammations cause a burning sensation. After a while, vesications appear on the psoriatic areas which later turn into pustules. In certain areas of the skin, they later form large lesions. The inflammation can affect any part of the skin (the scalp as well). When several months have passed since the appearance of the early signs and symptoms of the disease, they either vanish or affect new areas of the skin. This is a recurrent disease.

Acrodermatitis Continua of Hallopeau

The main peculiarity of this kind of dermatosis are pustular formations the origin of which remains unknown. They are mainly located in the acral areas (hands and soles). The disease manifests itself in the form of small inflammations (no more than 0.5 cm). The boundaries of the inflammations are very clear. Eventually, the pustules burst. These pustules form erosive surfaces covered with purulent crusts. Acrodermatitis continua of Hallopeau is a chronic and progressive disease. Gradually, adermotrophia and morphea-like changes develop on the sites of inflammation.

Impetigo Herpetiformis

Taking into consideration the observations of the scientists, the disease typically occurs in pregnant women and it much less affects children and adult males. The first symptoms of this type of the disease appear suddenly. Lesions appear as painful pustules. These pustules are mainly concentrated in the groin, armpits, and inner thigh.

Another form of the disease is localized pustular psoriasis. This form is classified into:

Localized form of Hallopeau disease

Localized pustular psoriasis is a disease that affects the pubic area of the skin. It may also appear on the background of psoriasis vulgaris.

Barber’s pustular psoriasis

Barber’s pustular psoriasis is chronic and undulating. It may appear on the basis of plaque psoriasis. The lesions typical of the disease occur on the surface of the hands and feet. Eventually, the pustules dry up and form a thick brown crust. The disease is also known as palmar pustular psoriasis and plantar pustular psoriasis.

Annular psoriasis

Some scientists describe another type of pustular psoriasis called annular psoriasis. It is usually subacute or chronic. It is more typical of children than of adults. Patients with this diagnosis usually experience skin manifestations without any general signs of the disease.

Pustular Psoriasis Treatment

As we have mentioned before, the occurrence of this severe disease can be brought about by a number of reasons. Pustular psoriasis occurs when patient’s general health condition deteriorates and is usually accompanied by high temperature, an increase of erythrocyte sedimentation rate, and leukocytosis. In this case, the patient experiences burning sensation and pain in the areas of inflammation. New pustules appear in an undulatory manner. They form purulent spots. Fever always accompanies the appearance of new areas of inflammation. The patient is usually hospitalized with this diagnosis. Pustular psoriasis treatment is believed to be the very effective if there is a combination of drugs (retinoids), photochemotherapy, and PUVA therapy. It takes a lot of time and efforts to treat pustular psoriasis, treating of this type of the disease is a very complicated process.

Unfortunately, modern medicine still cannot cure psoriasis completely. The disease is undulating. It means that the period of remission may be followed by the period when health condition gets much worse. Remission may even last for several years. Unfortunately, psoriatic plaques usually appear again. It is caused by a number of triggering factors. Modern methods of treatment can significantly reduce the signs of pustular psoriasis and improve patient’s quality of life.

The treatment depends on the severity and the specific form of the disease. Sometimes pustular psoriasis may be very mild and the patient may not even know about being sick. However, enhanced by a number of reasons (hormonal disorders, stress, and disorders the immune system, for instance), the disease can turn more acute and severe. If the skin of the patient is significantly covered with inflammation areas, he or she has to be taken to the hospital. It must be mentioned that neither form of the disease is contagious. When choosing the methods of treatment, the doctors consider various factors. Usually, they prescribe a complex therapy.

Home Remedies for Pustular Psoriasis

We have already mentioned that true causes of psoriasis are still a mystery for the scientists. Unfortunately, modern medicine is unable to completely cure this disease. Though people from ancient times have been effectively fighting the disease.

There are quite effective home remedies for pustular psoriasis used by various nations all over the world. The secret of each recipe is the medical composition that is traditionally used as a natural treatment for pustular psoriasis. A variety of tinctures, ointments, and baths with herbs will be very effective for the patient. But every patient’s reaction to the various components will depend on the organism peculiarities. This should be considered when choosing natural treatments.

Usually, the disease becomes acute in winter and spring. The peculiarities of the disease don’t always allow to treat the patients at the hospital. Only severe forms of the disease are the sign to hospitalize patients. Therefore, it is possible to deal with psoriasis at home. Here are some useful tips on traditional medicine.

  • Try to add essential oils to the bath and rub them into the affected areas of the skin (bergamot, chamomile, geranium, jasmine, rose, and lavender).
  • Drink herbal tea made of soft soothing herbs (chamomile, lavender, mint, lime blossom).
  • Apply marigold ointment to the affected areas.
  • Ingest sea buckthorn oil (a teaspoon per day) and apply the sea buckthorn oil to exfoliations.

When talking about natural treatment of the disease, one should first consider one’s diet. Patients should eat less fatty food, carbohydrates, spicy food, and drink no alcohol.

In general, treatment of pustular psoriasis requires a long-term complex treatment under medical supervision. One should contact the doctor for self-medication of an acute form of the disease may deteriorate the health condition of the patient. Don’t forget that this disease may be the initial stage of skin cancer. It is always better to consult a specialist.