# Complications and Laboratory Test Findings Among Patients With Generalized Pustular Psoriasis: A Retrospective Chart Review Study

**Authors:** Ryuhei Okuyama, Yukari Okubo, Shinichi Imafuku, Yayoi Tada, Keiichi Yamanaka, Kazumitsu Sugiura, Yukie Yamaguchi, Masahito Yasuda, Wataru Sakamoto, Morihisa Saitoh, Akimichi Morita

PMC · DOI: 10.1111/exd.70227 · Experimental Dermatology · 2026-03-16

## TL;DR

This study finds that patients diagnosed with generalized pustular psoriasis often have multiple skin-related complications and unrelated health issues.

## Contribution

The study provides new insights into the frequency of psoriasis-related and non-psoriasis-related comorbidities at GPP diagnosis in Japan.

## Key findings

- Most patients with GPP had psoriasis-related complications like psoriasis vulgaris and psoriatic arthritis.
- Non-psoriasis-related comorbidities such as hypertension and diabetes were also common.
- There was significant variability in laboratory test results among patients.

## Abstract

Generalized pustular psoriasis (GPP) is a rare, chronic, inflammatory skin disease characterised by widespread eruption of sterile, macroscopic pustules. Patients with GPP can present with multiple comorbidities that may influence treatment. This study aimed to assess the frequency of psoriasis‐related complications and non–psoriasis‐related comorbidities, and clinical laboratory findings, at the time of GPP diagnosis among patients with GPP. This was a retrospective, longitudinal medical chart review of data from patients with a documented GPP diagnosis attending 29 GPP referral hospitals in Japan. Demographics and clinical characteristics were assessed at baseline (within 6 months prior to and 3 months after GPP diagnosis), including psoriasis‐related complications, non–psoriasis‐related comorbidities, and clinical laboratory findings. Overall, 205 patients with GPP were included; 48.3% were female, and median age at initial diagnosis was 53 years. Similar proportions of patients had mild (36.1%), moderate (30.7%) and severe (33.2%) GPP at baseline, using Japanese Dermatological Association‐GPP severity criteria. Most patients (69.8%) had psoriasis‐related complications at baseline, with the most common being psoriasis vulgaris (42.9%) and psoriatic arthritis (26.8%). Non–psoriasis‐related comorbidities were present in 69.3% of patients with GPP at baseline, with the most common being hypertension (28.3%), dyslipidaemia (16.6%) and diabetes mellitus (16.1%). There was large variability in laboratory test values between patients. These results demonstrated that, at the time of GPP diagnosis, patients with GPP have multiple burdens of both psoriasis‐related complications and non–psoriasis‐related comorbidities.

## Linked entities

- **Diseases:** Generalized pustular psoriasis (MONDO:0100491), psoriatic arthritis (MONDO:0011849), dyslipidaemia (MONDO:0002525), diabetes mellitus (MONDO:0005015)

## Full-text entities

- **Genes:** IL36RN (interleukin 36 receptor antagonist) [NCBI Gene 26525] {aka FIL1, FIL1(DELTA), FIL1D, IL-36Ra, IL1F5, IL1HY1}, ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}, CD79A (CD79a molecule) [NCBI Gene 973] {aka IGA, IGAlpha, MB-1, MB1}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}
- **Diseases:** tongue cancer (MESH:D014062), Keratoconjunctivitis (MESH:D007637), tumour (MESH:D009369), tonsillitis (MESH:D014069), CKD-MBD (MESH:D012080), thyroid tumour (MESH:D013964), metabolic (MESH:D008659), respiratory disorders (MESH:D012131), hepatobiliary disorders (MESH:D004066), eruption (MESH:D003875), erythroderma (MESH:D003873), autoinflammatory (MESH:D056660), inflammatory skin disease (MESH:D012871), inflammation (MESH:D007249), cardiac failure (MESH:D006333), hypertension (MESH:D006973), death (MESH:D003643), obesity (MESH:D009765), iritis (MESH:D007500), septic shock (MESH:D012772), oedema (MESH:C536897), infection (MESH:D007239), gastrointestinal disorders (MESH:D005767), GPP (MESH:D011565), diabetes (MESH:D003920), acute respiratory distress syndrome (MESH:D012128), capillary leak syndrome (MESH:D019559), immune system disorders (MESH:D007154), cardiovascular disease (MESH:D002318), uveitis (MESH:D014605), systemic (MESH:D015619), renal and urinary tract disorders (MESH:C566906), PsA (MESH:D015535), psychiatric disorders (MESH:D001523)
- **Chemicals:** methotrexate (MESH:D008727), cyclosporine (MESH:D016572), Calcium (MESH:D002118), GPP (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12992671/full.md

## References

33 references — full list in the complete paper: https://tomesphere.com/paper/PMC12992671/full.md

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Source: https://tomesphere.com/paper/PMC12992671