An Exploratory Study to Identify Factors Associated with Recurrence of Generalized Pustular Psoriasis Flares in Adult Patients in Japan.

Generalized pustular psoriasis (GPP) is a rare, systemic inflammatory disease characterized by a heterogeneous and often unpredictable clinical course involving chronic symptoms and recurrent flares. Due to the rarity of GPP, our understanding of factors associated with flare recurrence remains unclear. Using an existing data set of adult patients with GPP in Japan, we performed univariate and multivariate analyses to investigate potential factors related to GPP flare recurrence, including patient demographics,  treatment and severity of baseline flare. In total, 150 patients with a baseline flare were included in this analysis; 27.3% (n=41) experienced flare recurrence during the follow-up period (mean duration: 4.16 years). For the overall population, 56.0% of patients were male (n=84), the mean age at baseline was 55.5 years, and the mean body mass index was 24.3 kg/m2. Based on the Cox proportional hazards model, comorbid diabetes mellitus, a fever of ≥38.5°C at baseline flare, experience of flare(s) prior to baseline and certain respiratory infections were associated with a higher risk of flare recurrence, similar to previously published findings. These results could help identify patients at risk of GPP flares; however, clinically applicable prediction of GPP flares requires further research in a wider population.