Burden of illness and unmet needs in generalized pustular psoriasis: report of four cases

Abstract

Generalized pustular psoriasis (GPP), the most severe form of pustular psoriasis, is a rare autoinflammatory skin disease that manifests with the rapid and widespread eruption of small, sterile pustules and surrounding skin erythema, often accompanied by systemic symptoms. GPP is frequently painful and distressing and adversely affects patients’ quality of life. Until recently, systemic treatment for GPP in the United States mainly involved the off-label use of agents approved to treat plaque psoriasis. In September 2022, spesolimab was approved in the United States as a first-in-class treatment for GPP flares in adults, making a GPP-specific therapy available. Here, we describe 4 cases from our respective clinical practices that highlight the difficulties faced by patients with GPP in receiving an accurate diagnosis and obtaining effective treatment and demonstrate the associated physical and psychological disease burdens. The potential severity and consequences of untreated GPP necessitate a prompt diagnosis, initiation of effective treatment, and regular follow-up and monitoring of patients’ conditions. When managing GPP, a multidisciplinary approach is recommended to ensure that patients receive appropriate social and emotional support and effective medical care.