Current status of generalized pustular psoriasis: Findings from a multicenter hospital-based survey of 127 Chinese patients.

Haimeng WANG; Jiaming XU; Xiaoling YU; Siyu HAO; Xueqin CHEN; Bin PENG; Xiaona LI; Ping WANG; Chaoyang MIAO; Jinzhu GUO; Qingjie HU; Zhonglan SU; Sheng WANG; Chen YU; Qingmiao SUN; Minkuo ZHANG; Bin YANG; Yuzhen LI; Zhiqiang SONG; Songmei GENG; Aijun CHEN; Zigang XU; Chunlei ZHANG; Qianjin LU; Yan LU; Xian JIANG; Gang WANG; Hong FANG; Qing SUN; Jie LIU; Hongzhong JIN

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Current status of generalized pustular psoriasis: Findings from a multicenter hospital-based survey of 127 Chinese patients.

Author: Haimeng WANG ¹ ; Jiaming XU ¹ ; Xiaoling YU ² ; Siyu HAO ³ ; Xueqin CHEN ⁴ ; Bin PENG ⁵ ; Xiaona LI ⁵ ; Ping WANG ⁶ ; Chaoyang MIAO ⁷ ; Jinzhu GUO ⁸ ; Qingjie HU ⁹ ; Zhonglan SU ¹⁰ ; Sheng WANG ¹¹ ; Chen YU ¹² ; Qingmiao SUN ¹³ ; Minkuo ZHANG ¹⁴ ; Bin YANG ² ; Yuzhen LI ³ ; Zhiqiang SONG ⁴ ; Songmei GENG ⁵ ; Aijun CHEN ⁶ ; Zigang XU ⁷ ; Chunlei ZHANG ⁸ ; Qianjin LU ⁹ ; Yan LU ¹⁰ ; Xian JIANG ¹¹ ; Gang WANG ¹² ; Hong FANG ¹³ ; Qing SUN ¹⁴ ; Jie LIU ¹ ; Hongzhong JIN ¹
Author Information

1. Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China.
2. Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong 510091, China.
3. Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, China.
4. Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing 400038, China.
5. Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China.
6. Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
7. Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100044, China.
8. Department of Dermatology, Peking University Third Hospital, Beijing 100191, China.
9. Hospital of Dermatology, Chinese Academy of Medical Sciences, Nanjing, Jiangsu 210042, China.
10. Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
11. Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
12. Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China.
13. Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
14. Department of Dermatology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Publication Type:Multicenter Study
Keywords: Burden; Comorbidities; Generalized pustular psoriasis; Misdiagnosis; Recurrence; Symptoms; Treatments
MeSH: Humans; Male; Female; Psoriasis/pathology*; Adult; Cross-Sectional Studies; Adolescent; Child; Young Adult; Quality of Life; Middle Aged; China/epidemiology*; Recurrence; Risk Factors; Surveys and Questionnaires; East Asian People
From: Chinese Medical Journal 2025;138(8):953-961
CountryChina
Language:English
Abstract: BACKGROUND:Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited.
METHODS:This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed.
RESULTS:Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P = 0.021) and transitioning to plaque psoriasis ( P = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP.
CONCLUSIONS:The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.