Pustular Psoriasis Treatment
Pustular psoriasis is a comparatively rare type of psoriasis in which the raised bumps develops all over the skin that contains yellow or clear, pustular fluid. Due to inflammation the baseline skin becomes reddened. It looks like regular psoriasis before it turns into pustular psoriasis. After a bout of pustular psoriasis is over it may also appear like regular psoriasis. This type of psoriasis is comparatively less scaly than the regular type of psoriasis so the reddened base is quite obvious. The pustular psoriasis can be either acute or chronic, and it solely depends on the length of the disease. This disease can become severe if it covers the entire body because the ability of the body to maintain its temperature and fluid balance is affected.
Itching, white blisters surrounded with red skin and painful skin includes some common symptoms of this condition. These are mostly developed on the trunk, arms and legs. Psoriasis is considered as sub acute or chronic as it affects the entire body. There are symptoms other than skin as well which includes fever and Zumbush type, which is actually a toxic reaction in the tissues.
Pustular psoriasis is also of several types. One of the types is a generalized one, as discussed above. This type causes toxic reactions in the tissues of the body and it is called the “von Zumbusch” type. Another type is ring-shaped in which ring is formed on the skin that is normally chronic or sub-acute. Palmoplantar pustulosis is also a type in which pustules are formed on the feet and hands.
This type of psoriasis is quite as it affects less than 10 people/million. This disease can affect all races, in adults, this disease can affect both women and men equally. At onset the average age is fifty years, slightly more than the average of psoriasis patient.
Major Causes of Pustular psoriasis
This condition can occur due to number of causes. Those who are on high dose of steroids and suddenly stop taking them are prone to this condition. Some other drugs can also trigger the pustular psoriasis, like trazodone, Lithium, iodine topical preparations, salicyclates such as aspirin, there are some nonsteroidal anti-inflammatory drugs, penicillin, Calcipotriol or antimalarial drugs, used for treating psoriasis. There are some very strong skin irritants that can also cause it which includes zinc shampoo, coal tar and anthralin, occlusive steroids. Some infections can also trigger this type of psoriasis, as can chemotherapeutic agents, phototherapy, low blood calcium and liver jaundice.
Pustular Psoriasis can also be triggered due to skin injury. When the skin is injured, the immune system start producing T cells so that infection can be killed off and white blood cells help in repairing any damage to the body. A serious or untreated injury or wound could trigger the malfunctioning T cells.
It is quite surprising that pregnancy can trigger Pustular Psoriasis. This happens because during pregnancy, a body of woman goes through different complex as well as difficult changes. Hormones and other chemicals alter quickly. The immune system gets confused and starts functioning abnormally. Pregnant women must be cautious regarding this condition.
The rays of sun can cause skin issues like skin cancer. Pustular Psoriasis is also another issue. The T cells can change to change in a non-cancerous way due to radiation from the sunlight. As a result they get confused, function abnormally and start attacking the skin. Wearing a strong sun block is important especially when exposed to the sun for long duration and when you are suffering from or prone to skin issues.
Another factor that can trigger this issue and other health issue is stress. Pustular Psoriasis is also one of them. Due to stress the body can react in number of ways. Stress is a psychological issue so the body is not equipped to deal with it. The stress related pains, aches, exhaustion and anxiety usually don’t make any sense to the immune system, because the body is not injured in any way that it can sort out. Due to confusion the body will often start attacking the skin.
Treatment of Pustular Psoriasis
The selection of pustular psoriasis treatment solely depends on the severity of the case. Sometimes the sufferers of pustular psoriasis need to be hospitalized so that adequate fluid and body temperature can be maintained. Even pustular psoriasis can put a strain on the sufferer’s heart so careful monitoring for heart injury or stress is essential. Applying compresses to the skin can work also undergoing saltwater solution baths and compresses can work in this regard, oatmeal baths and other treatment options that cure the pustules and protect from secondary infection.
For treating skin affected with pustular psoriasis topical agents can be used. Some common topical agents include vitamin D3 analogues, coal tar preparations, vitamin A derivatives (retinoids), corticosteroids and anthralin. In order to achieve best effects some doctors rotate these topical treatments. Anthralin can work effectively with salicylic acid included in the cream or ointment, while salicylic acid is contraindicated in creams vitamin D3 analogues containing creams like a combination can inactivate the vitamin D3 analogues.
Pustular psoriasis can also be treated with light therapy. The source of light can either be sun or from special UVA lamps or UVB lamps. UVB light is strong but UVA light is not strong so medications like psoralens are used for sensitizing skin to the light in conjunction with UVA light and this therapy is known as PUVA. The possible side effects of this therapy include burning of the skin and skin cancer.
For reducing inflammation systemic therapy when used in the form of biologics or retinoids like Enbrel and Humira work well in case of pustular psoriasis. Both systemic therapy and light therapy in combination can give good results. In case of systemic therapy an injection is given every two weeks.
Treatment of Von Zumbusch Pustular Psoriasis
There are three forms of pustular psoriasis as per the National Psoriasis Foundation. Von Zumbusch psoriasis—also called generalized pustular psoriasis—painful reddening of large part of skin is the main feature that occurs several hours later by formation of pustule. These pustules dry up within one to two days these and then fall off. This can further lead to disruption of the normal protective functions of the skin. Some symptoms linked with these disruptions include chills, fever, dehydration, rapid pulse, muscle weakness, exhaustion, anemia, weight loss and severe itching.
Seeking immediate medical treatment is essential for those suffering from the symptoms of Von Zumbusch. Initial treatment can be started after confirming diagnosis. Using antibiotics to fight against infection is considered as the typical first step; in case of dehydration the patient may be hospitalized as well. When you condition is stabilized then your doctor will use medication to fight against the overproduction of skin cells that is causing the problem of psoriasis. Some common options are acitretin (Soriatane), cyclosporine and methotrexate. When the acute phase of the condition passes, then the patient you may be treated with limited or controlled doses of UV light in conjunction with an oral drug psoralen for light-sensitizing.
Treating Palmoplantar Pustulosis
Palmoplantar pustulosis (PPP) —also called as localized pustular psoriasis—its main feature is the pustules formation on the soles of the feet and on palms. Those who have this disorder, they experience a reddening of the skin followed by formation of pustules groups that turn its color to brown then peel and crust over. The initial treatment for PPP normally starts with the topical medications. Some other common options include coal tar, salicylic acid, corticosteroids, synthetic vitamin D as well as a class of drugs known as topical retinoids. In case of persistent symptoms treatment is done with acitretin, Methotrexate or cyclosporine and also UV light therapy.
Acropustulosis is a pustular psoriasis which is quite rare in which the lesions are formed at the toes or fingertips that can give rise to painful deformities in the nails and it can also change the local structure of the bone. For this disorder as well doctors treat with the same systemic medications like they treat other types of psoriasis. It is not easy to manage acropustulosis in some cases, as it may take time to find the right and effective option of treatment.
Home Remedies to Treat Pustular Psoriasis
It’s not only pain that is associated with psoriasis blisters. They can be a source of entry for bacteria and germs into the body to cause infections. It is important to keep the skin clean and free from infections in order to treat any type of psoriasis. Bathe every day in a warm but not hot, bath. Soak for 15 minutes in Epsom salt water, colloidal oatmeal or mild oil can also be helpful for calming and cleaning the skin. Gently remove scales gently with a piece of soft cloth. Oil-rich or thick, moisturizer must be applied after bathing, before starting your day, and also before bedtime. With plastic wrap or cloth, wrap affected parts after moisturizer application for sleeping.
For blistery and inflamed skin it is better to use over-the-counter lotions or medicated creams must be included into daily routine. Always choose products that contain hydrocortisone and salicylic acid.