Generalised Pustular Psoriasis During Pregnancy: What Are the Symptoms?

Pregnancy brings about numerous changes in the body, including skin issues. Recently, the story of a woman who endured a difficult time with a rare skin condition called generalised pustular psoriasis during her pregnancy has emerged. Around her sixth month of pregnancy, a rash that started on her back gradually spread across her entire body, causing her extreme pain. Initially mistaken for a common rash, the symptoms worsened over time, eventually leading to cracked and peeling skin. As this case illustrates, generalised pustular psoriasis during pregnancy can bring unexpected suffering.

What is Generalised Pustular Psoriasis?

Generalised pustular psoriasis is an inflammatory skin condition characterised by widespread redness of the skin accompanied by small, pus-filled blisters. This condition arises from an immune response and is not related to bacterial infections, meaning it is not contagious. It can occur even in individuals who have not previously suffered from psoriasis. Symptoms include skin pain, itching, pustules, and scaling. In severe cases, it can lead to systemic symptoms such as high fever, chills, and muscle aches.

Causes and Symptoms During Pregnancy

The exact causes of generalised pustular psoriasis during pregnancy are not yet fully understood, but hormonal changes and alterations in the immune system are considered major contributing factors. It is known that excessive activation of a substance called interleukin-36 (IL-36) triggers skin inflammation. Additionally, the following factors may influence its onset:

• Hormonal changes due to pregnancy
• Stress
• Use of certain medications
• Discontinuation of systemic steroids

These symptoms typically appear in the later stages of pregnancy and can persist even after childbirth. Therefore, it is advisable to seek medical attention immediately if symptoms arise.

Diagnosis and Treatment Methods

The diagnosis of generalised pustular psoriasis is made by comprehensively considering the appearance of the skin rash, systemic symptoms, and medical history. In severe cases, hospitalisation may be necessary. Treatment methods include fluid and electrolyte replacement, pain management, and skin moisturisation. If needed, medications such as cyclosporine, methotrexate, and biologics can be used. Notably, a drug called Spesolimab (Spevigo) effectively blocks the IL-36 receptor, offering targeted treatment.

Since the range of medications that can be used during pregnancy is limited, collaboration between obstetricians and dermatologists is crucial. Early diagnosis and appropriate treatment are therefore paramount for generalised pustular psoriasis during pregnancy. If symptoms appear, it is best to visit a dermatologist as soon as possible for an accurate diagnosis.