Pustular Psoriasis is a skin disease which is rare but when it occurs the patient has rashes on the feet and hands. The treatment of Pustular Psoriasis is often characterized by aggressive treatment procedures which doctors have attributed to its popularity over the past few years. Treatment of Pustular Psoriasis is mostly carried out using cytostatics and corticosteroids, and this has been the basis of this argument. Of all the cases of Pustular Psoriasis, 60% are of patients with a history of vulgar psoriasis while only 40%are reported at new cases among healthy people. There are currently three types of Pustular Psoriasis which dermatologists have come up with to differentiate the clinical courses involved in each: chronic, subacute and acute pustular psoriasis.
One of the biggest concerns among healthy people is whetherPustular Psoriasis is contagious. Doctors describe the manifestation of Pustular Psoriasis as either localized or generalized and none of these two has been known to be contagious.
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Generalized pustular psoriasis
Von Zumbusch pustular psoriasis, Acrodermatitis persistans (Hallopeau’s disease), Impetigo herpetiformis are all terms used to describe generalized pustular psoriasis.
#1 Von Zumbusch pustular psoriasis
Perfectly healthy people are prone to getting this kind of infection which the main symptom is erythema. This is an inflammation of the skin which usually feels hot to touch and causes a burning kind of pain. The inflammation stays on for some time before vesicles appear on the psoriatic foci which later transforms into psoriatic pustules. There are some areas of the skin which these painful spots will merge to form a larger lesion focus. These points of inflammation can occur on any part of the body including the scalp. The disease is usually recurrent in nature and while the first spot may be noticed earlier, subsequent infections may either appear in the same area or new positions.
#2 Acrodermatitis persistans also known as Hallopeau’s disease
The hands and soles of the feet are the areas which this type of pustular psoriasis occurs. It is not known where they originate from, but they form small inflammations with clear boundaries that measure up to 0.5cm in diameter. With time, these pustules ill burst to form erosive surfaces and the area gets a crust cover. Hallopeau’s disease is progressive and, therefore, chronic in nature. Skin atrophy and sclerodermoid gradually develop on inflamed areas of the hands and feet.
#3 Impetigo herpetiformis
According to scientific studies carried out among patients, this type of generalized psoriasis is common in women when they are expectant and typically does not affect men and children. The initial symptoms will appear suddenly as skin rashes which are extremely painful. Pustules can normally be found in the armpits, inner thighs area, and inguinal region.
#4 Localized pustular psoriasis
This type of pustular psoriasis is divided into three;
- Localized version of Hallopeau’s disease known also as acrodermatitis continua. The localized psoriasis pustular disease affects the pubis It often occurs in patients who already have Psoriasis Vulgaris.
- Barber’s pustulosis is also known as pustulosis palmaris et plantaris. Palmoplantar pustular psoriasis is the other name that this type of psoriasis can be referred to. Barber’s pustulosis is persistent and undulating in nature. It may also occur together with Psoriasis Vulgaris. A typical rash lesion of a Pustular psoriasis infection appears on the feet and hands. After some time, the area of the pustules becomes dry, leaving a thick brown crust. Palmar-plantar pustular psoriasis though it can be quite unpleasant, is not a dangerous disease.
- Psoriasis that advances to postulation. Occurring as a result of the treatment of Psoriasis vulgaris, this type manifests with the appearance of pustules at the site where the Psoriasis Vulgaris foci had been.
Treatment of Pustular psoriasis
Treatment for Pustular psoriasis does not follow a strict regimen, and usually, patients will present themselves to the doctor for a treatment course to be determined. Pustular psoriasis is often effectively treated with a combination of photochemotherapy, PUVA therapy, and retinoids. The treatment of Pustular psoriasis is quite complicated because the course of treatment changes from one individual to the other, treatment takes a long time and must be complimented with a special diet.
In severe cases of Pustular psoriasis, the underlying factors usually include hormonal disorders, stress, infection or the treatment of Psoriasis Vulgaris. By the time Pustular psoriasis is detected to be the cause of ill health the patient’s health has deteriorated greatly. The onset of fever raised erythrocyte sedimentation rate and leukocytosis usually lead to the diagnosis. As new pustules form in various foci, there is a direct relation to the fever and complaint of pain in the inflamed regions.
Exudative form of Psoriasis
This type of infection occurs in patients with a history of hypothyroidism, obesity, and diabetes. Patients will usually notice grayish-yellow lesions that appear to have loose scales. There is also localized burning and itchiness in the affected areas.
Treatment of Exudative psoriasis
The treatment method employed in the cure of psoriasis depends on the type of infection identified and the severity of the lesions. Most of the times, patients are not even aware that they are sick because the infection may at the time be mild or slow in progression. The treatment regime a patient is put on depends on the overall health condition at the time, stress levels and strength of the immune system. It has happened in some cases that the lesions spread and form loci in almost every part of the body causing severe pain and discomfort. Such cases are usually hospitalized for observation. Though there is no standard for the treatment of all psoriasis cases, modern medicine has managed to improve the quality of life of patients.
