{"id":6790,"date":"2020-04-23T04:46:19","date_gmt":"2020-04-23T07:46:19","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/psoriasis-pustulosa-generalizada\/"},"modified":"2020-04-27T16:52:44","modified_gmt":"2020-04-27T19:52:44","slug":"generalized-pustular-psoriasis","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/psoriasis-pustulosa-generalizada\/","title":{"rendered":"Generalized pustular psoriasis."},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/psoriasis-pustulosa-generalizada\/#Que-es-generalizado-pustuloso-%C2%BFpsoriasis\" >What is generalized pustular psoriasis?<\/a><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/psoriasis-pustulosa-generalizada\/#Psoriasis-pustulosa-generalizada\" >Generalized pustular psoriasis.<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/psoriasis-pustulosa-generalizada\/#%C2%BFQue-causa-la-psoriasis-pustulosa-generalizada\" >What causes generalized pustular psoriasis?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/psoriasis-pustulosa-generalizada\/#%C2%BFCuales-son-los-signos-y-sintomas-de-la-psoriasis-pustulosa-generalizada\" >What are the signs and symptoms of generalized pustular psoriasis?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/psoriasis-pustulosa-generalizada\/#Sistemico-sintomas\" >Sist\u00e9mico s\u00edntomas<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/psoriasis-pustulosa-generalizada\/#%C2%BFComo-se-diagnostica-la-psoriasis-pustulosa-generalizada\" >How is generalized pustular psoriasis diagnosed?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/psoriasis-pustulosa-generalizada\/#%C2%BFCuales-son-las-complicaciones-de-la-psoriasis-pustulosa-generalizada\" >What are the complications of generalized pustular psoriasis?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/psoriasis-pustulosa-generalizada\/#%C2%BFQue-tratamiento-hay-disponible-para-la-psoriasis-pustulosa-generalizada\" >What treatment is available for generalized pustular psoriasis?<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"Que-es-generalizado-pustuloso-%C2%BFpsoriasis\"><\/span>What is it <span class=\"term\" data-term-id=\"308\">generalized<\/span> <span class=\"term\" data-term-id=\"792\">pustular<\/span> psoriasis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Generalized pustular psoriasis is a rare and serious skin disorder that presents with outbreaks of <span class=\"term\" data-term-id=\"309\">extended<\/span> sterile <span class=\"term\" data-term-id=\"1016\">pustules<\/span> on a background of red and tender leather. Also known as <span class=\"term\" data-term-id=\"349\">acute<\/span> generalized pustular psoriasis of von Zumbusch.<\/p>\n<p>Related pustular disorders include:<\/p>\n<ul>\n<li><span class=\"term\" data-term-id=\"1056\">Subcorneal<\/span> pustular <span class=\"term\" data-term-id=\"60\">skin disease<\/span><\/li>\n<li>Acute generalized <span class=\"term\" data-term-id=\"376\">exanthematous<\/span> <span class=\"term\" data-term-id=\"1130\">pustulosis<\/span> (AGEP)<\/li>\n<li>\n<span class=\"term\" data-term-id=\"1475\">Palmoplantar<\/span> pustulosis (hands and feet)<\/li>\n<li>\n<p>Acrodermatitis continua of Hallopeau (pustulosis of <span class=\"term\" data-term-id=\"1268\">digits<\/span>)<\/li>\n<\/ul>\n<section class=\"textBlock imageLinkBlockTitle\">\n<h5 class=\"colour--primary\"><span class=\"ez-toc-section\" id=\"Psoriasis-pustulosa-generalizada\"><\/span>Generalized pustular psoriasis.<span class=\"ez-toc-section-end\"><\/span><\/h5>\n<\/section>\n<section class=\"imageLinkBlock\">\n<div class=\"flex\">\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='ps-pust1__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-8506534-5898583' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/ps-pust1__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-8506534.jpg'>\n<\/div>\n<p class=\"p-small\">pustular psoriasis<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='ps-pust2__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildg1xq-5681405-3688966' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/ps-pust2__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsInkiLDg1XQ-5681405.jpg'>\n<\/div>\n<p class=\"p-small\">pustular psoriasis<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='ps-pust3__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildzd-7634097-6305937' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/ps-pust3__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDZd-7634097.jpg'>\n<\/div>\n<p class=\"p-small\">pustular psoriasis<\/p>\n<\/p><\/div>\n<\/section>\n<div class=\"clearfix imageLinkBlock\"><\/div>\n<p>See more images of generalized pustular psoriasis.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-causa-la-psoriasis-pustulosa-generalizada\"><\/span>What causes generalized pustular psoriasis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Generalized pustular psoriasis is a <span class=\"term\" data-term-id=\"490\">inflammatory<\/span> Skin illness. Recent research suggests that generalized pustular psoriasis is distinct from psoriasis, with a different pattern of immune activation. Generalized pustular psoriasis has been associated with abnormalities in the <span class=\"term\" data-term-id=\"433\">cytokine<\/span> (messenger protein) <span class=\"term\" data-term-id=\"915\">interleukin<\/span> -36-<span class=\"term\" data-term-id=\"782\">receiver<\/span>-signaling antagonist. This is due to recessive <em>IL36RN<\/em> <span class=\"term\" data-term-id=\"774\">gene<\/span> <span class=\"term\" data-term-id=\"871\">mutations<\/span>. These mutations are also found in some patients with AGEP, palmoplantar pustulosis, and acrodermatitis continua of Hallopeau.<\/p>\n<p>About 10% of patients with generalized pustular psoriasis have a history of psoriasis, in which there is persistence, <span class=\"term\" data-term-id=\"37\">circumscribed<\/span>, Red and <span class=\"term\" data-term-id=\"385\">scaly<\/span> <span class=\"term\" data-term-id=\"368\">plates<\/span>. In these patients, gain-of-function abnormalities of the CARD14 gene have been reported.<\/p>\n<p>Possible triggers for generalized pustular psoriasis flare-ups may include:<\/p>\n<ul>\n<li>Sudden withdrawal from injected or oral corticosteroids.\n<\/li>\n<li>Medications such as lithium, aspirin, indomethacin, iodide, and some beta-blockers.<\/li>\n<li>\n<span class=\"term\" data-term-id=\"145\">Infection<\/span>.<\/li>\n<\/ul>\n<p>Generalized pustular psoriasis sometimes arises in pregnancy. Formerly known as impetigo herpetiformis, this name is no longer favored because the <span class=\"term\" data-term-id=\"704\">eruption<\/span> has nothing to do with impetigo (a <span class=\"term\" data-term-id=\"937\">bacterial<\/span> infection) or herpes simplex (a viral infection).<\/p>\n<p>Strong, irritating <span class=\"term\" data-term-id=\"1330\">current<\/span> preparations such as coal tar, dithranol, and withdrawal of strong topical corticosteroids can lead to <span class=\"term\" data-term-id=\"324\">located<\/span> areas of pustulosis, often associated with existing plaques of psoriasis.<\/p>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-los-signos-y-sintomas-de-la-psoriasis-pustulosa-generalizada\"><\/span>What are the signs and symptoms of generalized pustular psoriasis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Generalized pustular psoriasis is characterized by <span class=\"term\" data-term-id=\"805\">recurrent<\/span> acute rashes<\/p>\n<ul>\n<li>Initially, the skin becomes dry, fiery red and sensitive.<\/li>\n<li>Within hours, 2\u20133 mm pustules appear.<\/li>\n<li>After a day, the small pustules <span class=\"term\" data-term-id=\"386\">get together<\/span> to form lakes of pus<\/li>\n<li>These are dried and peeled to leave a smooth, glazed surface on which new cultures of pustules can appear.<\/li>\n<li>Successive cultures of pustules may appear and erupt every few days or weeks.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Sistemico-sintomas\"><\/span>\n<span class=\"term\" data-term-id=\"380\">Systemic<\/span> symptoms<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Flare-ups of generalized pustular psoriasis can cause:<\/p>\n<ul>\n<li>\n<span class=\"term\" data-term-id=\"1176\">Fever<\/span> and chills (or hypothermia)<\/li>\n<li>A headache<\/li>\n<li>rapid pulse<\/li>\n<li>Loss of appetite and nausea.<\/li>\n<li>Thirst and dehydration<\/li>\n<li>Muscular weakness<\/li>\n<li>Leg swelling.<\/li>\n<\/ul>\n<p><span class=\"term\" data-term-id=\"1260\">Remission<\/span> occurs within days or weeks and the skin returns to its previous state or <span class=\"term\" data-term-id=\"91\">erythroderma<\/span> can develop. <span class=\"term\" data-term-id=\"1501\">Relapses<\/span> They are common.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-diagnostica-la-psoriasis-pustulosa-generalizada\"><\/span>How is generalized pustular psoriasis diagnosed?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Generalized pustular psoriasis is often clinically suspected by experienced dermatologists. However, the following tests are usually done to confirm the diagnosis and identify potential complications.<\/p>\n<ul>\n<li>Laboratory tests for bacterial infection.<\/li>\n<li>\n<p>Skin <span class=\"term\" data-term-id=\"24\">biopsy<\/span>, showing superficial (subcorneal) pustules and <span class=\"term\" data-term-id=\"443\">neutrophilic<\/span> <span class=\"term\" data-term-id=\"543\">infiltration<\/span> in <span class=\"term\" data-term-id=\"129\">histopathology<\/span>\n<\/li>\n<li>Blood cell count<\/li>\n<li>Kidney and liver function<\/li>\n<li>Electrolytes, Calcium\/Phosphate<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-las-complicaciones-de-la-psoriasis-pustulosa-generalizada\"><\/span>What are the complications of generalized pustular psoriasis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Death can be the result of cardiorespiratory failure during the acute eruptive phase of generalized pustular psoriasis, so it is essential to treat it as soon as possible. Older patients are at higher risk. Other complications include:<\/p>\n<ul>\n<li>Secondary bacterial infection\n<\/li>\n<li>The blood count may show <span class=\"term\" data-term-id=\"598\">anemia<\/span>neutrophilia <span class=\"term\" data-term-id=\"1815\">lymphopenia<\/span>\n<\/li>\n<li>Elevated inflammatory markers such as <span class=\"term\" data-term-id=\"946\">C-reactive protein<\/span> (<span class=\"term\" data-term-id=\"947\">CRP<\/span>)<\/li>\n<li>Disturbed protein and electrolyte balance, low albumin, low calcium, and low zinc<\/li>\n<li><span>High output heart failure<\/span><\/li>\n<li>\n<span class=\"term\" data-term-id=\"896\">Renal<\/span> and liver failure<\/li>\n<li>protein losing enteropathy<\/li>\n<li>\n<span class=\"term\" data-term-id=\"1374\">Peripheral<\/span> <span class=\"term\" data-term-id=\"400\">neuropathy<\/span>\n<\/li>\n<li>Malabsorption of nutrients and <span class=\"term\" data-term-id=\"1150\">therapeutic<\/span> drugs<\/li>\n<\/ul>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-tratamiento-hay-disponible-para-la-psoriasis-pustulosa-generalizada\"><\/span>What treatment is available for generalized pustular psoriasis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Generalized pustular psoriasis can be fatal, so hospitalization is usually required. The goal is to prevent further fluid loss, stabilize body temperature, and restore electrolyte imbalance. Specialized care is essential.<\/p>\n<p>Affected areas are treated with soft topical compresses using <span class=\"term\" data-term-id=\"1888\">emollients<\/span> and low-potency topical steroid creams.<\/p>\n<p>Systemic medications may include:<\/p>\n<ul>\n<li>\n<p>Antibiotics for confirmed or suspected infection.<\/li>\n<li>Acitretin<\/li>\n<li>\n<p>Systemic corticosteroids (with caution)<\/li>\n<li>\n<p>Cyclosporine (with caution)<\/li>\n<li>Methotrexate<\/li>\n<li>Colchicine<\/li>\n<li>\n<p>Biologic agents including infliximab, etanercept, ustekinumab, adalimumab, and anakinra.<\/li>\n<\/ul>\n<p><span style=\"font-size: 1rem;\">Anti-IL36 <span class=\"term\" data-term-id=\"466\">monoclonal<\/span> <span class=\"term\" data-term-id=\"426\">antibodies<\/span> are being evaluated for their effectiveness <\/span><span style=\"font-size: 1rem;\">in generalized pustular psoriasis.<\/span><\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>Que es generalizado pustuloso \u00bfpsoriasis? La psoriasis pustulosa generalizada es un trastorno cut\u00e1neo raro y grave que se presenta con brotes de extendido est\u00e9ril p\u00fastulas sobre un fondo de piel&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-6790","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/6790","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=6790"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/6790\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=6790"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=6790"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=6790"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}