A RECENT series of 25,000 dermatological patients examined over a period of years1 revealed 1,625 patients, or 6.5%, to have psoriasis. Of the latter, only 3 patients were diagnosed to have the rare variant of generalized pustular psoriasis.
Generalized pustular psoriasis was in fact first described in 1910 by von Zumbusch.2 Later, Schaeffer3 and Ebert4 further contributed to its understanding. This variant, occurring in psoriatic patients, is characterized by an explosive generalized eruption, marked by high fever and toxicity, without evident precipitating cause. The dermatitis progresses from early discrete and sterile pustules to shallow subcorneal layers of pus, then to dry, brownish crusts, and finally to a generalized exfoliation. The disease is cyclic in nature, associated with complete clearance of the disseminated pustular phase and unexplained reexacerbations. Reports of occasional fatalities are recognized.1,5 Möslein,6 in an extensive review of the literature up to 1958,