Pustular psoriasis usually occurs in adults. It is characterized by blister-like lesions filled with non-infectious pus and surrounded by reddened skin. Pustular psoriasis, which can be limited to one part of the body (localized) or can be widespread, may be the first symptom of psoriasis or develop in a patient with chronic plaque psoriasis.
Generalized pustular psoriasis is also known as Von Zumbusch pustular psoriasis. Widespread, acutely painful patches of inflamed skin develop suddenly. Pustules appear within a few hours, then dry and peel within two days.
Generalized pustular psoriasis can make life-threatening demands on the heart and kidneys.
Palomar-plantar pustulosis (PPP) generally appears between the ages of 20 and 60. PPP causes large pustules to form at the base of the thumb or on the sides of the heel. In time, the pustules turn brown and peel. The disease usually becomes much less active for a while after peeling.
Acrodermatitis continua of Hallopeau is a form of PPP characterized by painful, often disabling, lesions on the fingertips or the tips of the toes. The nails may become deformed, and the disease can damage bone in the affected area.
6-ThioguanineApproved for treating leukemia, it may be effective in treating psoriasis, especially pustular psoriasis. Possible side effects include anemia, decrease in white blood cells and platelets and bone marrow toxicity.
IsotretinoinFDA approved for the treatment of severe cystic acne, oral isotretinoin may also be effective in treating pustular psoriasis. Isotretinoin is a potent drug that can cause severe birth defects. For this reason, it should not be used by a woman who is pregnant or breast feeding. Women planning a pregnancy should discontinue taking isotretinoin and use birth control for at least one month before trying to become pregnant.
Non-traditional psoriasis treatments include:
*Soaking in warm water and German chamomile (Matricaria recutita) or bathing in warm salt water.
*Drinking as many as three cups a day of hot tea made with one or a combination of the following herbs: burdock (Arctium lappa) root, dandelion (Taraxacum mongolicum) root, Oregon grape (Mahonia aquifolium), sarsaparilla (Smilax officinalis), and balsam pear (Momardica charantia).
*Taking two 500-mg capsules of evening primrose oil (Oenothera biennis) a day. Pregnant women should not use evening primrose oil, and patients with liver disease or high cholesterol should use it only under a doctor's supervision.
*Eating a diet that includes plenty of fish, turkey, celery (for cleansing the kidneys), parsley, lettuce, lemons (for cleansing the liver), limes, fiber, and fruit and vegetable juices.
*Eating a diet that eliminates animal products high in saturated fats, since they promote inflammation.
*Drinking plenty of water (at least eight glasses) each day.
*Taking nutritional supplements including folic acid, lecithin, vitamin A (specific for the skin), vitamin E, selenium, and zinc.
*Regularly imagining clear, healthy skin.
