Pustular Psoriasis, one among the five types of Psoriasis, is a rare skin disease that usually occurs in adults. This uncommon form of Psoriasis is characterized by the appearance of clearly defined, raised bumps on the skin. These bumps or erections will be filled with noninfectious pus or pustules.
The skin under and around these white postules will be reddish in colour. The pus containing white blood cells is neither infectious nor contagious. These pus-filled blisters may dry out in a day or two days and may reappear every week.
An Overview of Psoriasis
Before going into the causes of Pustular Psoriasis, it will be beneficial to have an understanding of what Psoriasis is. Psoriasis can be briefly defined as an autoimmune disorder caused by one’s genes. This immune-mediated disease occurs in case when the immune system sends defective signals causing an accelerated growth cycle of skin cells. In a normal condition, skin cells require twenty-eight to thirty days to reach maturity; whereas the faulty signals by immune system shortens the skin cell regeneration process to three to six days.
This accelerated growth of skin cells also causes rapid maturity and death of the cells. This over build-up of dead skin cells leads to scaling, itching and inflammation of the skin. This condition is generally known as Psoriasis. The term Psoriasis’ origin can be traced to the Greek word ‘psora’, which means itch. Psoriasis can be generally classified into five varieties: Plaque psoriasis, Guttate Psoriasis, Inverse Psoriasis, Pustular Psoriasis and Erythrodermic Psoriasis.
Types of Pustular Psoriasis
This potentially very serious type of psoriasis can be classified in two categories depending on the spread of the disease across the body. They are Generalized Pustular Psoriasis (or von Zumbusch) and Localized Pustular Psoriasis. If the disease appears all over the body, it falls under the former category; and if it is limited to just one part of the body, it falls under the latter group. Generalized Pustular Psoriasis is considered to be a rare and serious form of Psoriasis.
Abrupt outbreak of reddened lesions will occur all over the body and urgent medical advice and hospitalization is required for this kind of Psoriasis. Again, Localized Pustular Psoriasis can be of two types. It is called Acropustulosis, when its appearance is limited only on the tips of the fingers, and Palmo-plantar pustulosis (PPP), when the postules occur on the palms of hands and/or the soles of feet.
Root Causes of Pustular Psoriasis
Normally, Generalized Pustular Psoriasis is a case of idiopathic, meaning, a disease that breaks out spontaneously with no specific identifiable cause. In other words, idiopathic is a medical term used for diseases that is triggered by an obscure or unknown cause. But still some causes are found out for the occurrence of Pustular Psoriasis.
Clinical studies have found out that people who are diagnosed with Putular Psoriasis generally have a history of the common type of Psoriasis. Psoriasis is generally considered as an ailment that runs in families. Medical experts have not yet discovered the precise way in which this illness gets transferred from generation to generation. Even though the tendency to contract psoriasis is stored in a person’s genes, no one can ever predict whether it will develop or not. Certain provocative factors are said to act as stimuli, leading to the sudden or gradual eruption of psoriasis in persons who have this hereditary tendency. For instance: alcohol, medicines and local irritation to the skin.
Some of the factors that are identified as the causes for General Pustular Psoriasis are:
1. Sudden withdrawal of systemic oral/injected corticosteroids – They include various prescribed drugs including Salicylates, often used to treat pain and fever; Iodine; antidepressants containing Lithium or trazodone; nonsteroidal anti-inflammatory drugs (NSAIDs); certain antibiotics such as Penicillin; antimalarial drugs; and Calcipotriol; chemotherapeutic agents and other high blood pressure drugs. Using these systemic steroids and suddenly withholding them act as triggers.
2. The use and sudden withdrawal of topical preparations, including coal tar, dithranol and strong topical corticosteroids.
4. Pregnancy – Pregnancy is the time when a woman’s body undergoes a lot of complex and difficult changes including quick change and alterations in hormones and other chemicals. All of these sudden changes in the body can initiate immune system confusion and malfunction.
5. Sunlight or phototherapy – In some people radiation from the sunlight can cause confused behaviour from the immune system.
6. Cholestatic jaundice
7. The condition of unusually low levels of calcium in the blood namely Hypocalcemia
8. High stress levels. Stress has been identified as a factor that can trigger skin inflammation. Psoriasis patients often find out that during high stress level situations, they experience a severe outburst of skin swelling.
The main factor that is identified as the trigger element for PPP is smoking. Clinical studies have proved that abnormal response to nicotine can trigger symptoms of Pustular Psoriasis. Therefore, those who have Psoriasis in their genes should refrain from smoking. Infections or stress are other factors that cause the outbreak of PPP. Although, the above-mentioned factors have been found out as the trigger elements of all types of Pustular Psoriasis, in certain patients, it is impossible to identify a trigger.
The established fact is that one’s immune system plays the major role in the outbreak of this disease and there are some triggers. The chance of contracting Psoriasis is increased if it is present in the heredity. Kids with one Psoriasis-diagnosed parent have 10% probability of contracting the disease; whereas, kids whose both parents suffer from Psoriasis have an increased 50% chance of contracting this disease.
It is important to isolate the trigger factor that causes the onset of this unpleasant skin condition. This is inevitable to prevent the breakout of Pustular Psoriasis in future and also helps in treating the disease effectively. Dangerous trigger factors should be avoided to keep pustular erections at bay. Making an analysis of your lifestyle for the previous weeks is the first thing to be done after diagnosed with Psoriasis. It includes the food you ate, various activities that you undertook, the stress level that you underwent etc. Since Generalized Pustular Psoriasis is known to threaten the proper functioning of heart and kidneys, it is essential to identify the exact causes before deciding on the proper treatment.