Pustular psoriasis is a rare and severe variant of psoriasis characterized by the eruption of sterile pustules, which may present in distinct clinical patterns. The pathologic features of psoriasis, including keratinocyte hyperproliferation, neutrophilic infiltration, and immune dysregulation, are markedly accentuated. Generalized pustular psoriasis (GPP) displays clinical heterogeneity in age of onset, severity, and disease course. Several overlapping phenotypes are recognized. A variable relationship exists between GPP and plaque psoriasis. Some individuals experience plaque psoriasis before or after GPP episodes, while others exhibit GPP as the sole phenotype without any history of plaque involvement (see Image. Pustular Psoriasis).
