Pustular Psoriasis Occurs Mostly in Adults
Pustular psoriasis is mostly seen in adults and is characterized by white pustules or blisters of non-infectious pus, and is surrounded by red skin. The pus is made up of white blood cells and is not contagious nor is it an infection. It is found locally in certain areas of the body such as the hands and feet and it is also found on most other parts of the body. There may be a cycle of reddening of the skin after which there may be a formation of pustules as also scaling.
A Number of Reasons Why it Occurs
Pustular psoriasis can often begin from taking internal medications, or from irritation topical agents or from being overexposed to ultra-violet light, pregnancy or even systemic steroids, infections, emotional stress as well as sudden withdrawal of systemic medications as well as from topical steroids of a potent kind.
Since there is potential for side effects of systemic medications and phototherapy, doctors often combine or rotate treatments for pustular psoriasis. And, according to many studies, Soriatane and methotrexate together can produce quick remission in acute pustular psoriasis and a consequent clearing of the skin.
The different kinds of pustular psoriasis include von Zumbusch, palmo-plantar pustulosis, and also acropustulosis. Von Zumbusch pustular psoriasis can begin abruptly and there is a widespread area of red skin which causes pain as well as tenderness in the skin.
Such a condition will rarely be seen in children, but in case it does appear, will improve much better than in the case of adults. The triggers that bring about von Zumbusch pustular psoriasis include infections, sudden withdrawal of topical or systemic steroids, pregnancy as well as drugs of the likes of lithium, propranolol as well as other high blood pressure drugs.
The other kind of pustular psoriasis is called palmo-plantar pustulosis which causes pustules on the palms or the hands and soles of the feet and is characterized by multiple pencil eraser-sized pustules in the fleshy parts of the hands and feet including the thumb and sides of the heels.
In case one is at risk of this form of pustular psoriasis, it is advisable to consider stopping smoking since nicotine has been shown to trigger flares of palmo-plantar pustulosis. It can be treated with topical treatments though it may be stubborn to treat, but PUVA, UVB, Soriatane, methotrexate or cyclosporine are used to clear it.
A rare form of pustular psoriasis is acropustulosis in which are seen skin lesions on the ends of the fingers as well as, in a few instances, on the toes. Eruptions may begin suddenly following an injury to the skin or due to infection, and in many instances; the lesions will cause pain and be disabling thus producing a deformity of the nails.
In severe cases, which are few and far between, bone changes can also occur and such instances are hard to treat. Patient’s topical preparations that are occluded will be helpful and systemic medications are also tried out with success in clearing of the lesions as well as to restore the nails.
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