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Boehringer Ingelheim Generalised Pustular Psoriasis

To learn more about Generalised Pustular Psoriasis (GPP), please select the most appropriate option. Please note you will be directed to a Boehringer site where you will also find information about other therapy areas

NP-GB-104950 Oct 2024

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Understanding GPP

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WHAT IS GPP?

Generalised Pustular Psoriasis (GPP) is a severe and potentially life-threatening neutrophilic skin disease characterised by episodes of widespread eruption of sterile, macroscopically visible pustules that occurs frequently with systemic inflammation.1 GPP can occur with or without plaque psoriasis, and the concurrence rates of up to 54.4% have been reported in GPP patients in the UK/Ireland.2

LEARN ABOUT GPP: WHAT'S IN A NAME

WHAT DOES GPP LOOK LIKE?

The clinical course of GPP is heterogeneous and can be characterised as a relapsing disease with recurrent flares with inter-flare periods of little to no activity, or a persistent disease with intermittent flares.1-3

GPP FLARES

GPP flares, also referred to as acute GPP, is characterised by neutrophilic pustules that coalesce to form lakes of pus on the skin. Flares can present with systemic symptoms (fever, increased C-reactive protein (CRP) and neutrophilia).3-6

GPP lare chest abdomen
microscopic gpp features

(A)

    
macroscopic-gpp-features

(B) 

Microscopic and macroscopic features of GPP. Histopathology of psoriasis. (A) Psoriasis vulgaris characteristically shows acanthosis, parakeratosis, and dermal inflammatory infiltrates. (B) In pustular psoriasis, acanthotic changes are accompanied by epidermal predominantly neutrophilic infiltrates, which cause pustule formation. (Reproduced from “Psoriasis Pathogenesis and Treatment” by Adriana Rendon and Knut Schäkel [Int. J. Mol. Sci. 2019; 20:1475; http://dx.doi.org/10.3390/ijms20061475] licensed under CC-BY 4.0).

WHAT  TRIGGERS GPP?

Recognising what triggers flares early may help you manage your patients' disease. GPP can be triggered by4-7:

SUNLIGHT

SUNLIGHT

Upper respiratory tract infection

UPPER RESPIRATORY TRACT INFECTIONS

Medication

CERTAIN MEDICATIONS

syringe

SUDDEN WITHDRAWAL OF STEROIDS

STRESS

STRESS

INFECTION

INFECTION

PREGNANCY

PREGNANCY

PAIN

PAIN

WHAT COMORBIDITIES ARE ASSOCIATED WITH GPP?   

Comorbidities may include6-8: 

  • Psoriatic arthritis
  • Diabetes
  • Hyperlipidemia
  • Obesity
  • Chronic obstructive pulmonary disease
  • Chronic kidney disease
  • Anxiety
  • Depression

WHAT COMORBIDITIES ARE ASSSOCIATED WITH GPP?

REFERENCES

  1. 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

  2. Twelves S, Mostafa A, Dand N et al. Clinical and genetic differences between pustular psoriasis subtypes. J Allergy Clin Immunol. 2019 Mar;143(3):1021-1026. doi: 10.1016/j.jaci.2018.06.038

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

  4. 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

  5. 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

  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. 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

  8. Prinz JC, Choon SE, Griffiths CEM et al. Prevalence, comorbidities and mortality of generalized pustular psoriasis: A literature review. J Eur Acad Dermatol Venereol. 2023 Feb;37(2):256-273. doi: 10.1111/jdv.18720

SC-GB-01617, May 2023