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Recognising GPP Flares

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Recognising GPP Flares

IDENTIFY THE CHARACTERISTICS OF GPP FLARES

Generalised pustular psoriasis (GPP) flares are characterised by episodes of eruptions of
neutrophilic pustules and worsening lesions.1 These symptoms can occur with or without
systemic inflammation and with or without plaque psoriasis.2,3

HOW GPP FLARES CAN MANIFEST ON PATIENTS' SKIN

The most-cited GPP symptoms include pustules and worsening lesions.1

GPP pustules 1

PATIENT HAS PROVIDED PERMISSION FOR THE USE OF THIS PICTURE

 

GPP Pustules 2

PATIENT HAS PROVIDED PERMISSION FOR THE USE OF THIS PICTURE

OTHER SYMPTOMS MAY INCLUDE1,4-7:

itching

ITCHING

scaling

SCALING

dryness

DRYNESS

painn

PAIN

swelling

SWELLING

burning-sensation

BURNING SENSATION

eryrhema

ERYTHEMA

fever

FEVER

leukocytosis

LEUKOCYTOSIS

joint-pain

JOINT PAIN

fatigue

FATIGUE

headache

HEADACHE

WATCH THE VIDEO FOR MORE ABOUT GPP FLARES

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GPP Flares
GPP Videos

When is GPP an emergency?

Speaker: "Professor Ricardo Romiti" and "Professor Diamant Thaci" 
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GPP FLARES MAY REQUIRE SAME-DAY MEDICAL
ASSESSMENT8

There are serious complications associated with GPP to consider. These include acute
respiratory distress syndrome (ARDS), sepsis, cardiovascular aseptic shock, high-output
cardiac failure, renal failure, neutrophilic cholangitis, metabolic abnormalities,
osteoarthritis, and uveitis. The most common causes of death associated with GPP are
sepsis, ARDS, and cardiac failure.2,5,6,9-11

THE UNPREDICTABLE NATURE OF FLARES MAKES
GPP CHALLENGING TO CONTROL9

GPP flares can vary among patients and present differently within the same patient.9
Because of this, previous flare episodes do not indicate the severity or duration of the next
flare.9 Due to the significant burden of disease, it is important to stabilise patients to
prevent escalation.2,6,9

LEFT UNTREATED, GPP SYMPTOMS CAN ESCALATE
AND MAY RESULT IN HOSPITALISATION AND BECOME
LIFE-THREATENING1,2,11

GPP can affect patients' quality of life.2,10 It can impact patients' social relationships and
mental health, and is associated with higher rates of anxiety and depression disorders.12,13

THE GENERALISED PUSTULAR PSORIASIS PHYSICIAN GLOBAL ASSESSMENT (GPPGA) SCORE CAN BE USED FOR ASSESSING FLARES14

The GPPGA is a scoring tool that can be used to assess the severity of flare symptoms. It was created by modifying the PGA, a clinical tool used by dermatologists to assess psoriasis.

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REFERENCES

  1. Strober B, Kotowsky N, Medeiros R, et al. Unmet medical needs in the treatment and management of generalized pustular psoriasis flares: evidence from a survey of Corrona registry dermatologists. Dermatol Ther (Heidelb). 2021;11(2):529-541. doi:10.1007/s13555-021-00493-0

  2. Gooderham MJ, Van Voorhees AS, Lebwohl MG. An update on generalized pustular psoriasis. Expert Rev Clin Immunol. 2019;15(9):907-919. doi:10.1080/1744666X.2019.1648209

  3. Navarini AA, Burden AD, Capon F, et al; for the ERASPEN Network. European consensus statement on phenotypes of pustular psoriasis. J Eur Acad Dermatol Venereol. 2017;31(11):1792-1799. doi:10.1111/jdv.14386

  4. Skalicky A, Rentz A, Esser D, Thoma C, Gloede T. Symptom experience of patients with generalized pustular psoriasis (GPP). Value in Health. 2020;23(suppl 1):S345. Abstract: PRO89. doi:10.1016/j.jval.2020.04.1310

  5. Bachelez H. Pustular psoriasis: the dawn of a new era. Acta Derm Venereol. 2020;100(3):adv00034. doi:10.2340/00015555-3388

  6. Choon SE, Lai NM, Mohammad NA, Nanu NM, Tey KE, Chew SF. Clinical profile, morbidity, and outcome of adult-onset generalized pustular psoriasis: analysis of 102 cases seen in a tertiary hospital in Johor, Malaysia. Int J Dermatol. 2014;53(6):676-684. doi:10.1111/ijd.12070

  7. Shah M, Al Aboud DM, Crane JS, Kumar S. Pustular psoriasis. StatPearls. Updated August 10, 2020. Accessed October 20, 2021. https://www.ncbi.nlm.nih.gov/books/NBK537002/

  8. Psoriasis: assessment and management. NICE Clinical Guideline [CG153]. National Institute for Health and Care Excellence. Published October 24, 2012. Updated September 2017. Accessed October 20, 2021. www.nice.org.uk/guidance/cg153

  9. Bachelez H. Pustular psoriasis and related pustular skin diseases. Br J Dermatol. 2018;178(3):614-618. doi:10.1111/bjd.16232

  10. Kharawala S, Golembesky AK, Bohn RL, Esser D. The clinical, humanistic, and economic burden of generalized pustular psoriasis: a structured review. Expert Rev Clin Immunol. 2020;16(3):239-252. doi:10.1080/1744666X.2019.1708193

  11. Ly K, Beck KM, Smith MP, Thibodeaux Q, Bhutani T. Diagnosis and screening of patients with generalized pustular psoriasis. Psoriasis (Auckl). 2019;9:37-42. doi:10.2147/PTT.S181808

  12. Sampogna F, Tabolli S, Söderfeldt B, Axtelius B, Aparo U, Abeni D; for the IMPROVE Investigators. Measuring quality of life of patients with different clinical types of psoriasis using the SF-36. Br J Dermatol. 2006;154(5):844-849. doi:10.1111/j.1365-2133.2005.07071.x

  13. Kotowsky N, Gao R, Singer D, Garry E, Golembesky AK. Healthcare resource utilization (HCRU) in patients with generalized pustular psoriasis (GPP): a claims database study. Value in Health. 2020;23(suppl 1):S333-S334. Abstract: PRO29. doi:10.1016/j.jval.2020.04.1257

  14. Burden DA, et al. AAD 2022. Poster 33547. Burden DA, et al. Am J Clin Dermatol. 2022;23(Suppl 1):39-50

SC-GB-01618, May 2023