Quality of life of patients with pustular psoriasis is inferior to that of patients with plaque psoriasis in Japan: A multicenter study with questionnaires, the short Form-36, and other patient-reported outcomes.

Generalized pustular psoriasis is a rare but severe form of psoriasis, accounting for 7.5% of all psoriasis cases. We investigated whether the disease burden and quality of life of patients with generalized pustular psoriasis were lower than those of patients with psoriasis vulgaris in Japan. Patients registered in the Western Japan Psoriasis Registry, a prospective cohort of patients with psoriasis treated at 31 facilities specializing in psoriasis medicine, were surveyed using the SF-36v2 and other patient-reported outcomes. We enrolled patients with generalized pustular psoriasis (n = 97) and psoriasis vulgaris (n = 1065). The generalized pustular psoriasis group had fewer males, were younger at onset, had fewer smokers and habitual drinkers, and were more frequently treated with biologics than patients with psoriasis vulgaris. Questions on disease burden revealed that patients with generalized pustular psoriasis experienced sores, blisters, skin pain, and systemic symptoms more frequently than patients with psoriasis vulgaris. A higher proportion of patients with generalized pustular psoriasis had joint pain and fatigue than those with psoriasis vulgaris, although patient satisfaction with treatment did not differ significantly between the two groups. The Short Form-36 evaluation revealed that patients with generalized pustular psoriasis had significantly lower physical component summary scores than patients with psoriasis vulgaris. These findings indicate that patients with generalized pustular psoriasis have a higher burden and more impaired quality of life than patients with psoriasis vulgaris.