If you have itchy red skin that's covered with tiny blisters filled with white or yellow pus, you may have pustular psoriasis. It's a rare skin disease that causes pain and itching. You may have fever, nausea, and other symptoms, too.
One form of pustular psoriasis that spreads to involve a large portion of your body needs to be treated at once by a doctor. See your doctor quickly if you think you might have it. They'll look at your skin, take a blood sample, and swab the pus that's inside a blister for a bacterial culture. Once your doctor learns that you have pustular psoriasis, they can offer treatment.
Many doctors send patients to the hospital if they have a type of pustular psoriasis that affects the whole body. This form of the disease can be life threatening. In the hospital, doctors and nurses will make sure you rest, are hydrated, and stay warm. They'll also ensure the disease doesn't strain your heart.
In non-severe cases of the condition, if your skin feels sore and itchy, put a cool compress on spots that bother you, or take oatmeal baths.
Your doctor may prescribe creams or ointments to provide relief. Some drugs work better for some people, so your doctor may have you try more than one before you find what works best.
Common ingredients in creams and ointments for pustular psoriasis include the active ingredient in aspirin (salicylic acid), vitamin D, vitamin A (retinoids), coal tar, steroids that are applied to the skin (corticosteroids), and a drug made from tree bark extract (anthralin).
Your pustular psoriasis may improve when you take pills or inject drugs that your doctor prescribes. They can help slow down your immune system, which is more active than it should be when you have this disease. Such drugs include:
- Acitretin (Soriatane), a vitamin A (retinoid) drug that you swallow
- Adalimumab (Humira), a drug that you inject under the skin
- Apremilast (Otezla), a pill that you swallow
- Certolizumab ( Cimzia) , a drug that you inject under the skin
- Cyclosporine ( Sandimmune ), a drug that you swallow
- Etanercept (Enbrel), a man-made protein that you inject under the skin
- Etanercept-szzs (Erelzi), also a man-made protein which you inject
- Infliximab (Remicade) a drug that you receive through the veins
- Methotrexate, a drug that may be swallowed or injected
Your doctor will want to see you every few weeks to months when you take these drugs to make sure they work well and don't cause problems. Tell your doctor if you plan to have a baby, because some of these drugs shouldn't be taken by women who intend to get pregnant.
Light Treatments (Phototherapy)
Some people with psoriasis improve when they get ultraviolet (UV) light treatments at a doctor's office. It isn't always helpful for pustular psoriasis, because too much UV light can cause or worsen symptoms.
Stress can cause or worsen pustular psoriasis symptoms. Try to do things to lower your stress levels, like exercise, yoga, tai chi, or meditation. Some people feel better, although no studies have proven this.
Your skin may improve if you eat more home-cooked foods made from scratch. Some people feel better if they avoid foods with gluten, which is found in wheat, rye, barley, and other grains. Still, no studies have proven that gluten can cause or worsen the disease. Ask your doctor before you change your diet.