National Psoriasis Foundation Medical Board releases its recommendations for treatment of pustular psoriasis

Doctors caring for patients with pustular psoriasis—a rare form of psoriasis characterized by white blisters surrounded by red skin—should consider the severity of the disease and the extent of involvement on the body when determining treatment, according to new consensus recommendations from the National Psoriasis Foundation Medical Board. They note that very limited data exists on the treatment options for pustular psoriasis and more study is needed.

The Medical Board recommends the following medications as first-line treatment for generalized, or widespread, pustular psoriasis: Soriatane (acitretin), methotrexate and cyclosporine. For patients with extensive, acute disease, the biologic agent Remicade also is recommended as a first-line therapy.

Further recommendations include the use of the biologics Humira and Enbrel, and light therapy known as PUVA—psoralen plus ultraviolet light A—as second-line treatments.

Children and pregnant women require special considerations due to treatment side effects. Soriatane, cyclosporine, methotrexate and Enbrel should be used as first-line therapies for juvenile pustular psoriasis followed by Humira, Remicade and UVB phototherapy for second-line treatment. For patients with pustular psoriasis in more localized areas—such as palmarplantar pustular psoriasis, which affects the palms of the hands and soles of the feet—topical steroids and light therapy are recommended as first-line treatment.

The treatment recommendations for pregnant women include first-line therapy with cyclosporine, oral corticosteroids and topicals, followed by light therapy as second-line treatment.

Learn more about the types of pustular psoriasis »

About the National Psoriasis Foundation

Serving its community through more than 50 years of patient support, advocacy, research funding, and education, the National Psoriasis Foundation (NPF) is the world’s leading nonprofit fighting for individuals with psoriasis and psoriatic arthritis. The NPF mission is to drive efforts to cure psoriatic disease and dramatically improve the lives of more than 8 million Americans affected by this chronic immune-mediated disease. As part of that effort, NPF created its Patient Navigation Center to offer personalized assistance to everyone with psoriasis or psoriatic arthritis. To date, NPF has funded more than $21 million in research grants and fellowships that help drive discoveries that may lead to more and better treatments and ultimately a cure. Learn more at