THE PROGNOSIS OF GENERALIZED PUSTULAR PSORIASIS TERENCE

Summary.— Data concerning 155 patients with all types of generalized pustular psoriasis have been reviewed. Generalized pustular psoriasis of Yon Zumbusch type is a severe disease. Thirty‐four of 106 patients followed up have died. In 26 of these, death was attributable to the disease or its treatment. G.P.P. developing from acral pustulosis (acrodermatitis continua) has the worst prognosis and is likely to prove fatal. G.P.P. evolving from ordinary, pustular palmo‐plantar or atypical fiexural forms of psoriasis has a better prognosis and may remit spontaneously. The use of steroids systemically for ordinary or erythrodermic psoriasis may precipitate G.P.P. and perpetuate the severe phase of psoriasis. Methotrexate is advocated for the treatment of the severe acute phase; but, in some patients, systemic steroid therapy cannot be avoided.