WEDNESDAY, May 1, 2024 -- International consensus has been achieved for the definition and diagnostic criteria for generalized pustular psoriasis (GPP). The consensus statement, issued by the International Psoriasis Council, was published online May 1 in JAMA Dermatology.

Siew Eng Choon, M.B.B.S., from Monash University in Johor Bahru, Malaysia, and colleagues developed an international consensus definition and diagnostic criteria for GPP. Based on expert reviews of 64 challenging GPP cases, 43 statements that comprehensively addressed the fundamental aspects of the definitions and diagnostic criteria for GPP were formulated. These statements were presented to a panel of 33 global GPP experts.

Consensus was achieved for 53 percent of the statements in the initial Delphi round, leading to the approval of 23 statements, which were then used to develop the proposed definitions and diagnostic criteria for GPP. The final definition was established in the second Delphi round and defined GPP as a "systemic inflammatory disease characterized by cutaneous erythema and macroscopically visible sterile pustules." GPP can occur with or without systemic symptoms, other types of psoriasis, and laboratory abnormalities. Manifestation can be as an acute form with widespread pustules or as a subacute form with an annular phenotype. The essential criterion identified was "macroscopically visible sterile pustules on erythematous base and not restricted to the acral region or within psoriatic plaques."

"The resulting definition and diagnostic criteria for GPP are intended to provide a clear and standardized framework for diagnosis, ultimately leading to improved patient care, enhanced epidemiological research, and a better understanding of the disease's impact on affected individuals," the authors write.

Several authors disclosed ties to the biopharmaceutical industry.