Skin and joint pain are common symptoms of generalized pustular psoriasis (GPP). While treating underlying inflammation in the long term is important, there are also short-term options to help manage pain.
Pustular psoriasis is a group of psoriatic conditions known to cause pus-filled breakouts. GPP is the most severe but rarest type of pustular psoriasis and is known to cause widespread pustules and other uncomfortable symptoms.
There’s currently no cure for GPP, and it has many possible causes. But all cases of GPP have one key characteristic in common: inflammation.
Like other types of psoriasis, GPP can cause a sudden onset of symptoms, which is known as a flare. A flare tends to last for at least a few weeks. During a GPP flare, you may experience a variety of severe symptoms that can affect your quality of life.
Not only do flares cause discomfort, but the underlying inflammation behind them can also be painful. Controlling this inflammation is key to managing pain in GPP.
If you or a loved one is experiencing pain related to GPP, consider talking with a doctor about the following treatments that may help manage it. You should also contact a medical professional right away if you experience a flare accompanied by a sudden onset of flu-like symptoms.
GPP is best known for its skin symptoms. Pain and burning sensations
In particular, GPP can cause a sudden outbreak of pustules that may appear all over your body or may sometimes be confined to one large area.
Pustules associated with GPP can be quite painful. When you have a GPP flare, you might first develop tender and sore skin, followed by a change in skin color. Depending on your natural skin tone, your skin might become unusually red, purple, or brown.
Numerous pustules can form and then burst open within a couple of days. Your skin can dry out and become more painful before the cycle repeats again.
Sometimes, pustules may form on your hands and feet and make it difficult and extremely painful for you to perform everyday activities such as walking, typing, and picking things up.
Managing skin pain due to GPP involves targeted treatments to help reduce pain and inflammation. Common treatments to try may include:
- topical corticosteroids
- emollient creams or lotions
- cool compresses
- synthetic vitamin D
Longer-term medications are also important for treating inflammation in GPP and preventing painful skin symptoms. A healthcare professional may prescribe:
- immunosuppressants such as methotrexate
- biologics such as spesolimab
- oral retinoids such as acitretin
- cyclosporine
While it’s
The level of pain can vary. You might experience chronic, severe joint pain, or the pain might be mild or intermittent.
Regardless of the intensity of your joint pain, it’s important to talk with a doctor about both short-term relief and long-term management. Over time, the underlying inflammation can damage your joints, making them stiff and increasingly difficult to move.
Options for short-term joint pain relief may include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve). Unlike other over-the-counter pain relievers, such as acetaminophen (Tylenol), NSAIDs can help target both pain and inflammation.
Still, short-term NSAID use does not address GPP inflammation in the long term. For this reason, a doctor may also recommend immunosuppressants or biologics that can help reduce symptoms of GPP while also reducing the number of flares you have.
As with other types of inflammatory joint pain, regular movement can help you feel better.
On the other hand, resting might make your joints hurt more. If you find that this is the case, you can ask a doctor about exercise programs that specifically target the joints affected by GPP, such as those in your hands, knees, or feet.
Low impact forms of exercise such as swimming, tai chi, and yoga may also reduce joint pain.
While the symptoms of GPP are most noticeable in your skin, you might also experience symptoms of pain outside of your skin and joints. Some of these types of pain may even indicate a medical emergency.
Talk with a doctor about the following types of pain that may be caused by GPP, as well as the different treatment options.
Infections
Infections are known triggers for GPP and related flares in some people with this condition. COVID-19, Streptococcus, Epstein-Barr virus, and varicella zoster virus are common GPP triggers.
If a doctor believes a bacterial or viral infection is the cause of your GPP flare and symptoms, they will prescribe medications that help treat the underlying infection. In addition to prescribing antibiotics or antivirals, a doctor will recommend that you increase your fluid intake as a supportive measure.
Headaches
Headaches can also be associated with inflammatory diseases such as GPP. While more research is needed to understand the exact link, one observational study from 2023 suggests a higher rate of migraine in people who have psoriasis.
If you need immediate relief for an acute headache, ask a doctor whether over-the-counter products, such as NSAIDs, are safe for you to take.
Flu-like symptoms
Skin or joint pain followed by fever and chills can indicate a potentially life threatening emergency. If you develop these flu-like symptoms along with GPP pain, it’s important to seek medical help right away.
Fatigue and emotional distress
When you have a chronic inflammatory disease like GPP, the pain and discomfort can understandably lead to fatigue and overall emotional distress. Pain that lasts longer than 6 weeks is associated with fatigue and worsening pain.
Addressing these symptoms can be just as important as treating skin and joint pain. In addition to your topical and systemic GPP treatments, talk with a doctor about ways you might be able to address fatigue and emotional distress.
Management may involve a combination of lifestyle strategies, such as exercise and eating a healthy diet. These can help reduce the inflammation that contributes to pain and help you feel more energetic.
A dermatologist (a doctor who specializes in skin conditions) might also adjust your GPP treatment plan. For example, methotrexate (Otrexup, Rasuvo) is an immunosuppressant sometimes prescribed for GPP, but it may cause fatigue as a side effect.
If GPP pain management alone does not improve your symptoms, a primary care doctor might refer you to a mental health professional who can help treat anxiety and depression.
GPP is a rare but serious form of pustular psoriasis. It can cause severe symptoms that may be quite painful.
Still, a variety of therapies can help manage your symptoms and improve your quality of life. One method of pain management involves targeting the underlying inflammation in the long term. But therapies are also available for short-term, localized pain.
Consider talking with a doctor about all these pain management options for GPP. They can help you determine whether your current GPP treatment plan is working or whether they need to adjust your medications.