I Was Diagnosed With Pustular Psoriasis. Do I Have An Infection?

Although the word “pustular” conjures the image of an infection or abscess, pustular psoriasis is not an infection. The pustular name describes the skin’s appearance, where yellow pus is seen scattered in blister-like areas beneath the surface of psoriatic skin. These pustules are sometimes referred to as “sterile pustules,” meaning that they are free of any bacteria or infection.

The presence of pus and yellow color is due to the presence of a type of white blood cell called a neutrophil, which usually attacks bacteria. In this situation, the neutrophils are being recruited to psoriatic skin without an infection, and instead of responding to infection, they form blisters full of pus.

Pustular psoriasis is not an infection, but it is possible for people with psoriasis to have infections of the skin at the same time. When people have psoriasis, it is possible to have a superinfection, meaning an infection that occurs at the same location of another skin disease, including psoriasis.

If one or two pustules occur on skin with psoriasis, and the area feels warm, swollen, or painful, it suggests that the pustules may be caused by an infection rather than the psoriasis alone.

Most of the medicines used to treat more common forms of psoriasis have also been used successfully to treat pustular psoriasis. Acitretin (sold as Soriatane), alone or in combination with other therapies, is chosen frequently as a treatment for this kind of psoriasis.

Pustular psoriasis can be associated with fever, chills, or abnormalities in blood chemistry. If pustules appear on the body, physician attention should be sought immediately.