Abstract
Von Zumbusch-type generalized pustular psoriasis is a rare and severe subtype of pustular psoriasis characterized by a rapid, widespread eruption of sterile pustules. The characteristic rash of this subtype may also be accompanied by systemic symptoms, including fever, polyarthritis, and edema. Flares of this condition may be triggered by infection, stress, or select medications. While tumor necrosis factor inhibitors are often utilized in the treatment of psoriasis vulgaris and various autoimmune diseases, these medications have also been reported to paradoxically induce generalized pustular psoriasis. This report describes one such case of von Zumbusch-type generalized pustular psoriasis induced by a tumor necrosis factor inhibitor utilized to treat the patient’s comorbid psoriatic arthritis. Prompt diagnosis and initiation of treatment with appropriate disease-modifying agents is essential in order to reduce the risk of serious adverse events associated with generalized pustular psoriasis, including cardiovascular failure and sepsis. This report illustrates successful early intervention with ixekizumab, leading to complete resolution of symptoms and avoidance of systemic complications. This case is presented with the intent to raise awareness of the clinical features of generalized pustular psoriasis and to share an effective treatment course of this rare and debilitating condition.