Profile of Generalized Pustular Psoriasis Inpatient Installation at Dr. Moewardi General Hospital Surakarta from January 2018-December 2022

Nurul Hidayati; Nurrachmat  Mulianto; Laura  Noviani; Lifesia Natali  Lidjaja

doi:10.37899/journallamedihealtico.v5i4.1584

Nurul Hidayati Department of Dermatology and Venereology, Faculty of Medicine, Sebelas March University, Dr. Moewardi Regional General Hospital, Surakarta
Nurrachmat Mulianto Department of Dermatology and Venereology, Faculty of Medicine, Sebelas March University, Dr. Moewardi Regional General Hospital, Surakarta
Laura Noviani Department of Dermatology and Venereology, Faculty of Medicine, Sebelas March University, Dr. Moewardi Regional General Hospital, Surakarta
Lifesia Natali Lidjaja Department of Dermatology and Venereology, Faculty of Medicine, Sebelas March University, Dr. Moewardi Regional General Hospital, Surakarta

DOI: https://doi.org/10.37899/journallamedihealtico.v5i4.1584

Keywords: Psoriasis,, Pustular psoriasis,, Immunosuppressant,, Corticosteroid

Abstract

Generalized pustular psoriasis (GPP) is a form of psoriasis characterised by the presence of sterile pustules. Its prevalence is between 2 and 3.5% of the population worldwide and in Indonesia it is 2.5% of the population. It can cause severe physical and psychosocial distress affecting the patient's quality of life. Objective: To describe the profile of GPP patients treated in the inpatient installation of Dr. Moewardi Hospital, Surakarta in the period of January 2018-December 2022. A retrospective descriptive study was conducted using the secondary data of medical records of GPP patients treated in the inpatient installation of Dr. Moewardi Hospital from January 2018 to December 2022. Results: In the 5-year period, there were 23 GPP inpatients, predominated by female (78.26%) with the age ranged from 5 to 74 years old. Generalised pustular psoriasis mostly affected the age group of 41- 50 years old (26.04%). Most patients were hospitalized for 6–10 days (39.13%). The most common therapy was immunosuppressant (65.2%) followed by oral corticosteroids (26.1%) and zinc (17.4%). Most patients also received moisturizer therapy (56.5%). Generalised pustular psoriasis mostly affects people aged between 41 and 50 years old. Females are more prone to GPP. The therapy given are oral immunosuppressive regimens, oral corticosteroids, zinc, topical corticosteroids and moisturizers.

References

Armstrong, A. W., & Read, C. (2020). Pathophysiology, clinical presentation, and treatment of psoriasis: a review. Jama, 323(19), 1945–1960. https://doi.org/10.1001/jama.2020.4006

Bachelez, H., Barker, J., Burden, A. D., Navarini, A. A., & Krueger, J. G. (2022). Generalized pustular psoriasis is a disease distinct from psoriasis vulgaris: evidence and expert opinion. Expert Review of Clinical Immunology, 18(10), 1033–1047. https://doi.org/10.1080/1744666X.2022.2116003

Benjegerdes, K. E., Hyde, K., Kivelevitch, D., & Mansouri, B. (2016). Pustular psoriasis: pathophysiology and current treatment perspectives. Psoriasis: Targets and Therapy, 131–144. https://doi.org/10.2147/PTT.S98954

Choon, S. E., Lai, N. M., Mohammad, N. A., Nanu, N. M., Tey, K. E., & Chew, S. F. (2014). Clinical profile, morbidity, and outcome of adult‐onset generalized pustular psoriasis: analysis of 102 cases seen in a tertiary hospital in Johor, Malaysia. International Journal of Dermatology, 53(6), 676–684. https://doi.org/10.1111/ijd.12070

Evanti, A. M., Kasmitasari, F., & Irawanto, M. E. (2022). Perbedaan Derajat Keparahan Penyakit Berdasarkan Skor Psoriasis Area and Severity Index (PASI) Terhadap Profil Lipid pada Psoriasis Vulgaris. Jurnal Health Sains, 3(5), 704–716. https://doi.org/10.46799/jhs.v3i5.494

Fujita H, Gooderham M, R. R. (2022). Diagnosis of psoriasis pustular generalisata.

Gisondi, P., Bellinato, F., & Girolomoni, G. (2020). Topographic differential diagnosis of chronic plaque psoriasis: challenges and tricks. Journal of Clinical Medicine, 9(11), 3594. https://doi.org/10.3390/jcm9113594

Gisondi, P., Bellinato, F., & Girolomoni, G. (2022). Clinical characteristics of patients with pustular psoriasis: a single-center retrospective observational study. Vaccines, 10(8), 1171. https://doi.org/10.3390/vaccines10081171

Ilona, S. E., & Irawanto, M. E. (2018). Psoriasis Pustulosa Generalisata Pada Remaja Yang Diterapi Dengan Injeksi Metotreksat. Media Dermato Venereologica Indonesiana, 45(2).

Kharawala, S., Golembesky, A. K., Bohn, R. L., & Esser, D. (2020). The clinical, humanistic, and economic burden of generalized pustular psoriasis: a structured review. Expert Review of Clinical Immunology, 16(3), 239–252. https://doi.org/10.1080/1744666X.2019.1708193

Kimmel, G. W., & Lebwohl, M. (2018). Psoriasis: overview and diagnosis. Evidence-Based Psoriasis: Diagnosis and Treatment, 1–16. https://doi.org/10.1007/978-3-319-90107-7_1

Kristiani, F. S., & Anggraini, D. I. (2020). Psoriasis pustulosa generalisata: tinjauan kasus pada geriatri. MEDULA, Medicalprofession Journal of Lampung University, 9(4), 692–698. https://doi.org/10.53089/medula.v9i4.236

Krueger, J., Puig, L., & Thaçi, D. (2022). Treatment options and goals for patients with generalized pustular psoriasis. American Journal of Clinical Dermatology, 23(Suppl 1), 51–64. https://doi.org/10.1007/s40257-021-00658-9

Li, L., You, J., Fu, X., Wang, Z., Sun, Y., Liu, H., & Zhang, F. (2019). Variants of CARD14 are predisposing factors for generalized pustular psoriasis (GPP) with psoriasis vulgaris but not for GPP alone in a Chinese population. British Journal of Dermatology, 180(2), 425–426. https://doi.org/10.1111/bjd.17392

Meier-Schiesser, B., Feldmeyer, L., Jankovic, D., Mellett, M., Satoh, T. K., Yerly, D., Navarini, A., Abe, R., Yawalkar, N., & Chung, W.-H. (2019). Culprit drugs induce specific IL-36 overexpression in acute generalized exanthematous pustulosis. Journal of Investigative Dermatology, 139(4), 848–858. https://doi.org/10.1016/j.jid.2018.10.023

Menter, A., Van Voorhees, A. S., & Hsu, S. (2021). Pustular psoriasis: a narrative review of recent developments in pathophysiology and therapeutic options. Dermatology and Therapy, 1–13. https://doi.org/10.1007/s13555-021-00612-x

Mirza, H. A., Badri, T., & Kwan, E. (2018). Generalized pustular psoriasis.

Miyachi, H., Konishi, T., Kumazawa, R., Matsui, H., Shimizu, S., Fushimi, K., Matsue, H., & Yasunaga, H. (2022). Treatments and outcomes of generalized pustular psoriasis: a cohort of 1516 patients in a nationwide inpatient database in Japan. Journal of the American Academy of Dermatology, 86(6), 1266–1274. https://doi.org/10.1016/j.jaad.2021.06.008

Morita, A., Kotowsky, N., Gao, R., Shimizu, R., & Okubo, Y. (2021). Patient characteristics and burden of disease in Japanese patients with generalized pustular psoriasis: results from the Medical Data Vision claims database. The Journal of Dermatology, 48(10), 1463–1473. https://doi.org/10.1111/1346-8138.16022

Parisi, R., Iskandar, I. Y. K., Kontopantelis, E., Augustin, M., Griffiths, C. E. M., & Ashcroft, D. M. (2020). National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. Bmj, 369. https://doi.org/10.1136/bmj.m1590

Raharja, A., Mahil, S. K., & Barker, J. N. (2021). Psoriasis: a brief overview. Clinical Medicine, 21(3), 170–173. https://doi.org/10.7861/clinmed.2021-0257

Rivera-Díaz, R., Daudén, E., Carrascosa, J. M., Cueva, P. de la, & Puig, L. (2023). Generalized pustular psoriasis: a review on clinical characteristics, diagnosis, and treatment. Dermatology and Therapy, 13(3), 673–688. https://doi.org/10.1007/s13555-022-00881-0

Romiti, R., Hirayama, A. L. da S., Arnone, M., & Magalhães, R. F. (2022). Generalized pustular psoriasis (von Zumbusch). Anais Brasileiros de Dermatologia, 97(01), 63–74. https://doi.org/10.1016/j.abd.2021.05.011

Shah, M., Al Aboud, D. M., Crane, J. S., & Kumar, S. (2019). Pustular psoriasis.

Twelves, S., Mostafa, A., Dand, N., Burri, E., Farkas, K., Wilson, R., Cooper, H. L., Irvine, A. D., Oon, H. H., & Kingo, K. (2019). Clinical and genetic differences between pustular psoriasis subtypes. Journal of Allergy and Clinical Immunology, 143(3), 1021–1026. https://doi.org/10.1016/j.jaci.2018.06.038

Wang, Q., Jin, L., Hu, K., Tan, M., Lu, Y., Zhao, Y., Chen, T., Chen, M., Zhu, W., & Kuang, Y. (2022). The length of stay and inpatient burden in inpatients with different psoriasis subtypes. International Journal of Medical Sciences, 19(10), 1519. https://doi.org/10.7150/ijms.67083

Zheng, M., Jullien, D., & Eyerich, K. (2022). The prevalence and disease characteristics of generalized pustular psoriasis. American Journal of Clinical Dermatology, 23(Suppl 1), 5–12. https://doi.org/10.6084/m9.figshare.16823503.