Treatment of generalized pustular psoriasis—clinical trials using different therapeutic modalities

Treatment of various types of pustular psoriasis, using dressings wet with Burow's solution alone, resulted in the clearing of pustules in 67 of 115 severe attacks in 26 mates and 21 females. The average number of days until spontaneous clearing was between 20 and 42; approximately one third of these attacks cleared within 20 days. Antichcmotactic medications such as tetracycline, dapsone and colchicinc cleared one third of the remaining non-spontaneously remitting attacks. The medications were ineffective in cases of chronic pustular eruption of the palms and soles for which a topical corticosteroid, with occlusion, was found to be useful. PUV A gave a favourable result in about half of cases of chronic drug-resistant pustular eruption of the trunk. Methotrexate CMTX) with or without non-steroidal anti-inflammatory agents could control cases of arthritis. Etretinate was efficient in treating two recalcitrant attacks; subsidence of the pustules occurred in I week. In conclusion, pustular psoriasis is a self-limited disease in cases of annular, exanthematous and impetigo herpetiformis, and in some cases of the von Zumbusch types. However, it may be a chronic, recurrent, progressive, intractable (especially the Hallopcau type), or rarely, even fatal disease. Methotrexate is not the drug of first choice for treating generalized pustular psoriasis.     

Mixed Lichen Planus-Lupus Erythematosus Disease

Two patients are reported with clinical symptoms of systemic lupus erythematosus associated with centrally ulcerated hypertrophic plaques and lip lesions. Histological findings from various sites were features of both lupus erythematosus and lichen planus. An increase in acid mucopolysaccharides and a thickened basement membrane which were present in some biopsies were interpreted as lupus erythematosus. The deposition of immunoglobulins and fibrinogen seemed to favor lupus erythematosus but these findings may also be seen in lichen planus. Four possible interpretations of the findings are discussed. The term "mixed lichen planus--lupus erythematosus disease" may be appropriate for these patients.