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Kołt-Kamińska M, Marek-Józefowicz L, Krajewski P, Nowowiejska J, Siekierko A, Duchnik E, Jóźwicka K, Kiedrowicz M, Mleczko M, Arasiewicz H, Kucharczyk M, Owczarek W, Walecka I, Szepietowski JC, Flisiak I, Lesiak A, Narbutt J, Marchlewicz M, Owczarczyk-Saczonek A, Krasowska D, Kręcisz B, Reich A. Characteristics of Patients with Generalized Pustular Psoriasis: A Report of the Polish Generalized Pustular Psoriasis Group. Dermatol Ther (Heidelb) 2024; 14:3379-3393. [PMID: 39572507 PMCID: PMC11604985 DOI: 10.1007/s13555-024-01306-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 10/30/2024] [Indexed: 11/30/2024] Open
Abstract
INTRODUCTION Data on generalized pustular psoriasis (GPP) in Poland are limited. Therefore, this study aimed to evaluate the demographic and clinical characteristics of Polish patients with GPP. In addition, the effect of the frequency of disease flares and the concomitant presence of psoriasis vulgaris (PV) on patient characteristics was evaluated. METHODS In this retrospective study, medical records of patients hospitalized for GPP in dermatology departments of the Polish Generalized Pustular Psoriasis Group were analyzed. RESULTS A total of 90 patients from 14 dermatology centers were included. The median age of patients was 59 (range, 5-85) years, and most patients were female (68.9%). The most common comorbidity was hypertension (43.3%), followed by cardiovascular diseases, diabetes, and hyperlipidemia. The median duration of GPP was 3 years, and the median number of flares was 2. Hospitalization was required in 67% of flares. The main triggering factors were drugs (20.5%) and infections (19.3%). Women and men with GPP differed in terms of age (p < 0.01), distribution of comorbidities, and selected triggering factors (stress: p < 0.05). Almost 25% of patients experienced more than one flare per year. Patients with different frequency of flares did not differ significantly in age, sex distribution, or comorbidities, but those with a higher frequency of flares had a shorter disease duration (median: 0.6 vs. 4.0 years; p < 0.01). In 59.1% of patients, GPP was accompanied by PV. Patients with GPP and PV were younger than those with GPP alone (median: 48.0 vs. 66.0 years; p < 0.01). CONCLUSIONS In this study, the general demographic and clinical characteristics of patients with GPP were consistent with those described in other studies. However, a high rate of flares requiring hospitalization and a significant percentage of patients experiencing more than one flare per year indicate the unmet need in the management of patients with GPP.
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Affiliation(s)
- Marta Kołt-Kamińska
- Department of Dermatology, Institute of Medical Sciences, Medical College of the University of Rzeszów, Rzeszów, Poland
| | - Luiza Marek-Józefowicz
- Department of Dermatology and Venerology, Faculty of Medicine, Nicolaus Copernicus University in Toruń, Ludwik Rydygier, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Piotr Krajewski
- Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, Wrocław, Poland
| | - Julia Nowowiejska
- Department of Dermatology and Venereology, Medical University of Bialystok, Białystok, Poland
| | - Aleksandra Siekierko
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Łódź, Poland
| | - Ewa Duchnik
- Department of Dermatology and Venereology, Pomeranian Medical University, Police, Poland
| | - Katarzyna Jóźwicka
- Department and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Magdalena Kiedrowicz
- Department of Dermatology and Venereology, Pomeranian Medical University, Police, Poland
| | - Mateusz Mleczko
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Hubert Arasiewicz
- Department of Dermatology and Vascular Anomalies, John Paul II Centre of Paediatrics, Sosnowiec, Poland
| | - Monika Kucharczyk
- Department of Dermatology, Jan Kochanowski University of Kielce, Kielce, Poland
| | - Witold Owczarek
- Department of Dermatology, Military Institute of Medicine, Warsaw, Poland
| | - Irena Walecka
- Department of Dermatology, Centre of Postgraduate Medical Education, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, Wrocław, Poland
| | - Iwona Flisiak
- Department of Dermatology and Venereology, Medical University of Bialystok, Białystok, Poland
| | - Aleksandra Lesiak
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Łódź, Poland
- Laboratory of Autoinflammatory, Genetic and Rare Skin Disorders, Medical University of Łódź, Łódź, Poland
| | - Joanna Narbutt
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Łódź, Poland
| | - Mariola Marchlewicz
- Department of Dermatology and Venereology, Pomeranian Medical University, Police, Poland
| | - Agnieszka Owczarczyk-Saczonek
- Department and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Dorota Krasowska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Beata Kręcisz
- Department of Dermatology, Jan Kochanowski University of Kielce, Kielce, Poland
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of the University of Rzeszów, Rzeszów, Poland.
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Gössinger E, Dodiuk-Gad R, Mühleisen B, Oon HH, Oh CC, Maul JT, Navarini AA. Generalized Pustular Psoriasis, Acute Generalized Exanthematous Pustulosis, and Other Pustular Reactions: A Clinical Review. Dermatol Clin 2024; 42:317-328. [PMID: 38423690 DOI: 10.1016/j.det.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Generalized pustular rashes have various etiologies and can be challenging to diagnose and manage at first presentation. The authors provide an in-depth analysis of common pustular skin eruptions including generalized pustular psoriasis (GPP) and acute generalized exanthematous pustulosis, focusing on their pathophysiology, triggers, clinical presentation, diagnostic challenges, and management strategies. The article also highlights recent advances in genetic research and biologic therapies for GPP and the future directions in personalized medicine and prevention strategies.
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Affiliation(s)
- Elisabeth Gössinger
- Department of Dermatology, University Hospital of Basel, Burgfelderstrasse 101, Basel 4055, Switzerland
| | - Roni Dodiuk-Gad
- Department of Dermatology, Emek Medical Center, Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, 3525433 Israel; Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario M5S 1A1, Canada
| | - Beda Mühleisen
- Department of Dermatology, University Hospital of Basel, Burgfelderstrasse 101, Basel 4055, Switzerland
| | - Hazel H Oon
- Department of Dermatology, Emek Medical Center, Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, 3525433 Israel; National Skin Centre and Skin Research Institute of Singapore (SRIS), 1 Mandalay Road, Singapore 308205, Singapore
| | - Choon Chiat Oh
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital of Zurich and Faculty of Medicine, Zurich 8091/8006, Switzerland
| | - Alexander A Navarini
- Department of Dermatology, University Hospital of Basel, Burgfelderstrasse 101, Basel 4055, Switzerland; Department of Biomedical Research, University of Basel, Allschwil 4123, Switzerland; Department of Biomedical Engineering, University of Basel, Allschwil 4123, Switzerland; Department of Clinical Research, University of Basel, Allschwil 4123, Switzerland.
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