Generalized pustular psoriasis (GPP) is a very rare form of psoriasis. It can cause inflammation throughout your body that can lead to heart, kidney, or lung failure. The condition needs to be taken very seriously.
Here’s a closer look at GPP: why it’s a health care emergency, signs you need immediate medical attention, and the importance of having an emergency plan.
Why GPP Is a Medical Emergency
GPP is a severe inflammatory skin condition. It causes red pustules (pus-filled blisters) to erupt on your skin. When GPP skin symptoms develop suddenly and intensely, it’s called a flare.
But the inflammation is more than just skin deep. It spreads throughout your body. This can lead to the following conditions:
- Loss of fluid, which can damage your kidneys
- Nutrient deficiencies (having a lack of certain nutrients)
- Liver damage
- Jaundice (yellowing of your skin and eyes)
- Acute respiratory distress
- Bacterial infections
- Hair loss
- Amyloidosis (where a protein called amyloid builds up in your organs and prevents them from working properly)
- Sepsis (a body-wide inflammatory response that can lead to organ failure)
If GPP is left untreated, the above complications can cause death.
Signs That You Need Immediate Medical Attention
The symptoms of GPP can vary. The most obvious sign is red pustules over large areas of your body. These may itch and be painful. If you see these, you need to call your doctor immediately. But if they show up with any of the following symptoms, you may need to head to the emergency room:
- Fever and chills
- Joint pain
- Muscle weakness
- Headache
- GI symptoms like nausea and diarrhea
- Swelling in your legs
- Red, painful eyes
- Fast heart rate
- Yellow skin and eyes
Since GPP is so rare, it may not always be recognized by doctors, especially in an emergency room. It can be confused with a skin infection or plaque psoriasis. But the symptoms aren’t the same. While all three conditions can show up as large areas of red, painful, itchy, and very dry skin, there are some key differences. Here’s what to stress to your emergency care team:
- Sterile pus-filled skin blisters, otherwise known as pustules. The most common spots are your arms, legs, trunk, or head.
- Fire-red skin that burns
- Fever or chills
- Joint pain
- Headache
- Extreme tiredness
- Muscle weakness
You may also want to carry a medical card with you that explains GPP. It should have the name and contact information of your dermatologist, as well as a list of medications that you currently take. You can find an example of one here.
Prepare for GPP Flares
If you have GPP, it’s important to eat a healthy diet. There are no studies that look specifically at GPP and nutrition. But in general, it’s recommended that people with psoriasis follow an anti-inflammatory diet, like the Mediterranean diet. Good foods to eat include:
- Fruits and vegetables
- Beans and lentils
- Nuts and seeds
- Whole grains
- Low-fat dairy
- Lean proteins, such as fish or plant-based proteins like tofu
- Olive oil
It’s also important to avoid the following:
- Alcohol
- Full-fat dairy
- Refined carbohydrates like white bread or pasta
- Red meat
- Processed food
You may want to also ask your doctor if you should get tested for celiac disease. People with psoriasis have higher rates of this condition. If you do have it, you’ll need to avoid gluten.
Plan ahead for when you’re sick, too. Make some healthy meals in advance and store them in your freezer. You can pop them in the oven or microwave if you have a flare and don’t feel well enough to cook. You can also order groceries online to throw together an easy meal. You can find some ideas for healthy recipes here.
Remember to also change your clothing during a flare. Wear clothes made of material that’s soft and breathable, like cotton. If you have pustules on your feet, wear socks with your shoes. You’ll also want to avoid extreme heat or cold. Stay out of the sun as much as you can.
You should prepare others for GPP flares, too. Let family, friends, and co-workers know that you have a condition that can appear suddenly and be very serious. You may want to draft a letter or email you can send out right away at the start of a flare. If you have kids, make sure you have backup caregivers in place.
If you have a GPP flare, you may need to take time off of work to get medical care. You may want to let your employer know that ahead of time, in case of an emergency hospitalization. Under the Americans with Disabilities Act, your job needs to provide reasonable accommodations for people with disabilities. This could include medical leave.
Pack an Emergency Bag
A GPP flare could land you in the hospital at any time. It’s a good idea to be prepared for it. Have a small overnight bag already ready with the following:
- Your health insurance card
- A form of personal ID, like a copy of your driver’s license
- A list of your doctors’ names, phone numbers, and emails
- Copies of health care forms like your advance directives, power of attorney, or living will
- A copy of your GPP medical card
- A list of medications including over-the-counter drugs and supplements, too
- Travel-size toiletries like a toothbrush, toothpaste, deodorant, soap, shampoo, conditioner, and a comb or hairbrush
- A change of clothing, including pajamas
You should also store all emergency contact information on your phone. This includes family, friends, neighbors, and anyone else you might need to reach out to if you end up in the hospital.
GPP is unpredictable. There’s no way to tell when you’ll have a flare and how severe it will be. But if you recognize the signs of a medical emergency and get care right away, it improves the odds that you’ll recover quickly and resume your normal life.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
National Organization for Rare Disorders: “Generalized Pustular Psoriasis.”
National Library of Medicine: “Generalized Pustular Psoriasis.”
Boehringer Ingelheim: “Preparing for Generalized Pustular Psoriasis.”
Johns Hopkins: “Psoriasis Diet: Foods to Eat and Avoid if You Have Psoriasis.”
U.S. Equal Employment Opportunity Commission: “Fact Sheet: Disability Discrimination.”
Dermatology and Therapy: “Unmet Educational Needs and Clinical Practice Gaps in the Management of Generalized Pustular Psoriasis: Global Perspectives from the Front Line.”
American Journal of Clinical Dermatology: “Clinical Course and Characteristics of Generalized Pustular Psoriasis.”
Rare Disease Advisor: “Generalized Pustular Psoriasis (GPP).”
