Generalized Pustular Psoriasis in Childhood: A Rare Case
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Background: Generalized pustular psoriasis (GPP) rarely occurs under 10 years of age. GPP is typically characterized by an eruption of generalized pustules accompanied by systemic symptoms such as fever for several days, malaise, and anorexia. Pustules are sterile, with a size of 2-3 mm, and spread over the trunk and extremities. This disease can be life-threatening; therefore, optimal therapy is required. Purpose: to report a rare case of GPP in childhood. Case: A 4-year-old girl with complaints of widespread red patches that spread to her neck, back, and hands, with red patches turning into streaks that are partially pus-filled and itchy. In almost all parts of the body, skin abnormalities were seen in the form of generalized erythematous plaques, well-defined borders, multiple pustules on the edges, and some plaques covered by thick scales and crusts. In the calculation of body surface area (BSA), the result is 44%, and in the calculation of generalized pustular psoriasis area and severity index (GPPASI), the result is 21.30. The patient was treated with combination topical therapy of 3% salicylic acid, desoximethasone cream 0.25%, momethasone cream 0.1% vaseline albume as emollients, and coal tar. Significant improvement was seen after 1 month of therapy. Discussion: GPP in children is a rare case. GPP is idiopathic and can be life-threatening. Until now, there has been no standard therapy that is considered the most effective and safe for children. Topical therapy may be an option.
Bramono K, Indriatmi W. Ilmu Penyakit Kulit dan Kelamin. 7th ed. Jakarta: Badan Penerbit FKUI; 2017. 213–222 p.
Gudjonsson J, Elder J. Psoriasis. In: Goldsmith L, Katz S, Gilchrest B, Paller A, Leffel D, editors. Fitzpatrick's Dermatology in General Medicine. 9th ed. New York: Mc Graw Hill; 2019. p. 457–97.
A. David B, Brian K. Psoriasis and Related Disorders. In: Griffiths C, Barker J, Bleiker T, Chalmers R, Creamer D, editors. Rook's Textbook of Dermatology. 9th ed. West Sussex: Wiley Blackwell; 2016. p. 35.1-35.48.
Grän F, Kerstan A, Serfling E, Goebeler M, Muhammad K. Current Developments in the Immunology of Psoriasis. Yale J Biol Med. 2020 Mar;93(1):97–110.
Yamanaka K, Yamamoto O, Honda T. Pathophysiology of psoriasis: A review. J Dermatol. 2021 Jun 22;48(6):722–31.
Schön MP, Erpenbeck L. The Interleukin-23/Interleukin-17 Axis Links Adaptive and Innate Immunity in Psoriasis. Front Immunol. 2018 Jun 15;9.
Hawkes JE, Chan TC, Krueger JG. Psoriasis pathogenesis and the development of novel targeted immune therapies. Journal of Allergy and Clinical Immunology. 2017 Sep;140(3):645–53.
Budianti WK, Anindya S, Debinta AA, Novianto E, Fitri EM, Effendi EH. Kesesuaian Tata Laksana Psoriasis Dengan Panduan Praktik Klinis (PPK) di RSUPN Dr. Cipto Mangunkusumo. Media Dermato-Venereologica Indonesiana. 2019;46(4):172–7.
Rasyidi F, Prawitasari S, Rofiq A. Psoriasis Pustular Generalisata Yang Diterapi Dengan Metotreksat. Dermato-Venereologica Indonesiana. 2020;47(2):83–7.
Fadillah L, Sofyan A, Hidayat N. Laporan Kasus : Psoriasis Pustulosa Generalisata Dengan Kejadian Berulang Yang Diinduksi Alergen. Jurnal Medical Profession (MedPro). 2019;1(1):50–4.
Ly K, Beck KM, Smith MP, Thibodeaux Q, Bhutani T. Diagnosis and screening of patients with generalized pustular psoriasis. Psoriasis: Targets and Therapy. 2019 Jun;Volume 9:37–42.
Sussman M, Napodano A, Huang S, Are A, Hsu S, Motaparthi K. Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis. Medicina (B Aires). 2021 Sep 23;57(10):1004.
Uribe-Herranz M, Lian LH, Hooper KM, Milora KA, Jensen LE. IL-1R1 Signaling Facilitates Munro's Microabscess Formation in Psoriasiform Imiquimod-Induced Skin Inflammation. Journal of Investigative Dermatology. 2013 Jun;133(6):1541–9.
Reich K, Augustin M, Gerdes S, Ghoreschi K, Kokolakis G, MöíŸner R, et al. Generalized pustular psoriasis: overview of the status quo and results of a panel discussion. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2022 Jun 8;20(6):753–71.
Burden AD, Choon SE, Gottlieb AB, Navarini AA, Warren RB. Clinical Disease Measures in Generalized Pustular Psoriasis. Vol. 23, American Journal of Clinical Dermatology. Adis; 2022. p. 39–50.
Patterson JW. The Psoriasiform Reaction Pattern . In: Weedon's Skin Pathology. 5th ed. Philadelphia: Elsevier; 2021. p. 99-120.e11.
Balan R, Grigoras A, Popovici D, Amalinei C. The histopathological landscape of the major psoriasiform dermatoses. Archive of Clinical Cases. 2019 Sep;06(03):59–68.
Elmets CA, Korman NJ, Prater EF, Wong EB, Rupani RN, Kivelevitch D, et al. Joint AAD–NPF Guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures. J Am Acad Dermatol. 2021 Feb;84(2):432–70.
Azizah F. Generalized pustular psoriasis and Cushing's syndrome in childhood due to corticosteroids misuse. Journal of General - Procedural Dermatology & Venereology Indonesia. 2021 Dec 31;5(3):176–80.
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