Ohata C, Tsuruta N, Yonekura K, et al. - Even in the era of biologics, etretinate affords a good treatment choice for generalized pustular psoriasis (GPP). The characteristics of Japanese pustular psoriasis unveiled herein can further assist effective GPP management.

• Data from the West Japan Psoriasis Registry were obtained to analyze 104 patients with pustular psoriasis and 1,290 patients with other subtypes of psoriasis.

• In pustular psoriasis, a significantly greater number of female patients, a significantly lower mean body mass index, and a significantly lower ratio of habitual drinkers were noted vs other subtypes of psoriasis.

• GPP was present in 102 of 104 patients, and the GPP without psoriasis vulgaris group showed a female predominance.

• Mean age at GPP onset was 45.3 years, an IL36RN gene mutation was present in four of nine patients with GPP, and 7.8% had a family history of psoriasis, and 24 patients with GPP were suffering from psoriatic arthritis.

• Biologics were the treatment of choice in 76.5%, etretinate was used in 37.3%, cyclosporine in 24.5%, methotrexate in 13.7%, apremilast in 8.8%.

• Etretinate was employed to treat 51.5% of patients with GPP with less than 10-year history.

• The most frequently noted comorbidity was hypertension, followed by diabetes.