Pustular Psoriasis

About 3 percent of people living with psoriasis develop pustular psoriasis.

It is often seen in older adults, although it can start at any age.

(Wilson et al., 2009)

Did You Know?


Symptoms of pustular [PUHS-choo-lar] psoriasis include pustules (white, pus-filled, painful bumps) that may be surrounded by inflamed or reddened/discolored skin. The pus in pustules is caused by inflammation and is not contagious. Those with pustular psoriasis generally go in a cycle of the reddening/discoloring of the skin, followed by pustules and scaling.

(Image curtesy of Callis-Duffin, University of Utah.)

Pustular psoriasis on the hand, found on the Symptoms section of the page.

There are different types of pustular psoriasis that depend on where the symptoms appear:

  • General pustular psoriasis (GPP) or von Zumbusch [vahn zuhm-BOOSH] psoriasis describes symptoms that affect large areas of the body. This type can develop suddenly and progress quickly and often comes with a fever, chills, severe itching, change in heart rate, fatigue and muscle weakness. See a health care provider immediately if you think you may have generalized pustular psoriasis.
  • Localized pustular psoriasis or palmoplantar pustular psoriasis (PPPP) is when symptoms affect the palms of the hands and/or the soles of the feet. This type often affects the base of the thumbs and the sides of the heels.
  • Acropustulosis [ak-roh-PUS-chool-loh-sis] is when symptoms affect only the tips of the fingers and/or toes. This type is very rare and may present after an injury to the skin or infection.


Several factors may trigger pustular psoriasis, including:

  • Certain medicines
  • Starting or stopping medicines
  • Exposure to too much ultraviolet (UV) light
  • Infections
  • Pregnancy
  • Stress


Topicals, phototherapy, oral treatments and biologics are all possible treatment options for pustular psoriasis. You and your health care provider will discuss the best treatment plan for you based on the severity of your symptoms and your medical history.

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Pustular Psoriasis Resource Center

NPF is here to help with resources, advice and stories specifically for you to help live the healthy and happy life that you want.

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Understanding Pustular Psoriasis

This rare type of psoriasis can be difficult to treat and live with, but dermatologists may soon have more effective, targeted therapies.

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Wilson, F. C., Icen, M., Crowson, C. S., McEvoy, M. T., Gabriel, S. E., & Kremers, H. M. (2009). Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum, 61(2), 233-239. doi:10.1002/art.24172

Last updated on 06/04/2021 by the National Psoriasis Foundation.

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