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Dermbits

BI Spevigo September 2023

DO, MPH

The use, tapering, or stopping of which medications can be associated with GPP?

Generalized Pustular Psoriasis (GPP)

This is actually kind of a complex question, because we know in basic patients that end up with GPP often may have plaque psoriasis in the background, and they may be out in the community, they might receive some IM steroids or some prednisone. And when they withdraw from the prednisone, because they're being treated with steroids, which are really not appropriate for psoriasis patients in general, they may end up with this acute or sometimes a flare or recurrent flares of what we now know as postural psoriasis. So we know one of these agents up that upon withdrawal are certainly corticosteroids. There are other agents, like analgesics, where this has happened, nonsteroidal antiinflammatory drugs, morphine, some antihypertensids, withdrawed patients in rare cases, like remipopril or diltiazam, other antihypertensives. I will also add for the audience that hydroxychloroquine, which we know has been responsible for potentially causing cases of plaque psoriasis or the appearance of plaque psoriasis. We also have seen cases where either upon the initiation of hydroxychloroquine or its withdrawal, we have seen the development of generalized pustular psoriasis. There are also some other interesting scenarios where we see GPP. Now, we mentioned before that an exclusion from the trial was acute generalized ectemicus postulosis, and that is a very different entity. But we have seen circumstances where certain drugs like penicillins, pristinomycin, sulf, anamides, even tribinophene, have caused pushal reactions that make it very tricky. And they are very much GPP, like.

The use, tapering, or stopping of which medications can be associated with GPP?

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