Published Paper Details:

Pustular psoriasis is a distinct subset of psoriasis that presents with involvement of the skin in the form of sterile pustules along with systemic manifestations. Though it has been conventionally grouped under the umbrella of psoriasis, recent research has shed light on its pathogenetic mechanisms associated with the IL-36 pathway, which is distinct from conventional psoriasis. Pustular psoriasis in itself is a heterogeneous entity consisting of various subtypes, including generalised, localised, acute, and chronic forms. There is confusion regarding its current classification as entities like deficiency of IL-36R antagonist (DITRA) which are closely related to pustular psoriasis both in their pathogenetic mechanism and its clinical manifestations, are not included under pustular psoriasis. Entities like palmoplantar pustulosis, which presents with similar clinical features but is pathogenetically distinct from other forms of pustular psoriasis, are included under this condition. Management of pustular psoriasis depends upon its severity; while some of the localised variants can be managed with topical therapy alone, the generalised variants like Von Zumbusch disease and impetigo herpetiformis may need intensive care unit admission and tailor-made treatment protocols. The advent of newer biologics and better insight into the pathogenesis of pustular psoriasis has opened the way for newer therapies, including tumour necrosis factor-alpha inhibitors, interleukin-1 inhibitors, interleukin-17 inhibitors, and granulocyte monocyte apheresis. Skin is the outermost covering of the body serving as a barrier between the external and internal environment. It is the largest organ of the body which acts as a first line of defense in providing resistance to the body. The aggravation of various Dhatus and Doshas result in skin diseases. More than one-fifty skin related diseases are mentioned in various Ayurvedic texts. They are categorized as Visarpa, Kustha, Shotha, Upadansha etc. Visarpa is a very common disease mentioned in Ayurvedic texts which spreads in body in various directions. It manifests as Daha, Jwara, Anunnatashopha and Vedana. Ayurveda consider Raktmokshana (blood sucking) and Pradeha (local application of drugs) as the best suitable treatment modalities for Visarpa.