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von Zumbusch (acute) generalized pustular psoriasis (acute GPP) is the most severe form of
generalized pustular psoriasis Generalized pustular psoriasis (GPP) is an extremely rare type of psoriasis that can present in a variety of forms. Unlike the most general and common forms of psoriasis, GPP usually covers the entire body and with pus-filled blisters rather than p ...
, and can be associated with life-threatening complications.


Signs and symptoms

Patients with acute GPP experience the eruption of multiple isolated sterile pustules generalized over the body, recurrent fevers, fatigue, and laboratory abnormalities (elevated ESR, elevated CRP, combined with leukocytosis).


Diagnosis

Kogoj's spongiform pustules can be observed via histopathology to confirm acute GPP.


Treatment

Acute GPP typically requires inpatient management including both topical and systemic therapy, and supportive measures. Systemic glucocorticoid withdrawal is a common causative agent. Withdrawal or administration of certain drugs in the patient's previous medication regimen may be required. Oral retinoids are the most effective treatment, and are considered first line. Cyclosporine or infliximab may be required for particularly acute cases.


History

The disorder has been named after Leo Ritter von Zombusch, who first described two cases of a brother and a sister in 1910. The patients experienced patterns of redness and pustule formation over several years, often associated with use of topical medications. Unfortunately one of the two siblings died from complications of the disease.


References


External links

{{Medical resources , ICD10 = L40.1 Psoriasis