Pustular Psoriasis: From Pathophysiology to Treatment

Genovese, Giovanni; Moltrasio, Chiara; Cassano, Nicoletta; Maronese, Carlo Alberto; Vena, Gino Antonio; Marzano, Angelo Valerio

doi:10.3390/biomedicines9121746

Open AccessReview

Pustular Psoriasis: From Pathophysiology to Treatment

by

Giovanni Genovese

^1,2,†

,

Chiara Moltrasio

^1,3,†

,

Nicoletta Cassano

⁴,

Carlo Alberto Maronese

^1,2

,

Gino Antonio Vena

^4,‡ and

Angelo Valerio Marzano

^1,2,*,‡

¹

Dermatology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy

²

Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, 20122 Milan, Italy

³

Department of Medical Surgical and Health Sciences, University of Trieste, 34137 Trieste, Italy

⁴

Dermatology and Venereology Private Practice, 76121 Barletta, Italy

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

^‡

These authors are both senior authors.

Biomedicines 2021, 9(12), 1746; https://doi.org/10.3390/biomedicines9121746

Submission received: 9 November 2021 / Revised: 18 November 2021 / Accepted: 19 November 2021 / Published: 23 November 2021

(This article belongs to the Special Issue Immune-Mediated Skin Diseases: From Pathophysiology to Novel Therapeutic Approaches)

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Abstract

Pustular psoriasis (PP) is a clinicopathological entity encompassing different variants, i.e., acute generalized PP (GPP), PP of pregnancy (impetigo herpetiformis), annular (and circinate) PP, infantile/juvenile PP, palmoplantar PP/palmoplantar pustulosis, and acrodermatitis continua of Hallopeau (ACH), which have in common an eruption of superficial sterile pustules on an erythematous base. Unlike psoriasis vulgaris, in which a key role is played by the adaptive immune system and interleukin (IL)-17/IL-23 axis, PP seems to be characterized by an intense inflammatory response resulting from innate immunity hyperactivation, with prominent involvement of the IL-36 axis. Some nosological aspects of PP are still controversial and debated. Moreover, owing to the rarity and heterogeneity of PP forms, data on prognosis and therapeutic management are limited. Recent progresses in the identification of genetic mutations and immunological mechanisms have promoted a better understanding of PP pathogenesis and might have important consequences on diagnostic refinement and treatment. In this narrative review, current findings in the pathogenesis, classification, clinical features, and therapeutic management of PP are briefly discussed.

Keywords: pustular psoriasis; generalized pustular psoriasis; palmoplantar pustular psoriasis; palmoplantar pustulosis; impetigo herpetiformis; acrodermatitis continua of Hallopeau; clinical features; pathogenesis; therapy

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MDPI and ACS Style

Genovese, G.; Moltrasio, C.; Cassano, N.; Maronese, C.A.; Vena, G.A.; Marzano, A.V. Pustular Psoriasis: From Pathophysiology to Treatment. Biomedicines 2021, 9, 1746. https://doi.org/10.3390/biomedicines9121746

AMA Style

Genovese G, Moltrasio C, Cassano N, Maronese CA, Vena GA, Marzano AV. Pustular Psoriasis: From Pathophysiology to Treatment. Biomedicines. 2021; 9(12):1746. https://doi.org/10.3390/biomedicines9121746

Chicago/Turabian Style

Genovese, Giovanni, Chiara Moltrasio, Nicoletta Cassano, Carlo Alberto Maronese, Gino Antonio Vena, and Angelo Valerio Marzano. 2021. "Pustular Psoriasis: From Pathophysiology to Treatment" Biomedicines 9, no. 12: 1746. https://doi.org/10.3390/biomedicines9121746

APA Style

Genovese, G., Moltrasio, C., Cassano, N., Maronese, C. A., Vena, G. A., & Marzano, A. V. (2021). Pustular Psoriasis: From Pathophysiology to Treatment. Biomedicines, 9(12), 1746. https://doi.org/10.3390/biomedicines9121746

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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