Mortality, Comorbidity Risk Increased With Generalized Pustular Psoriasis

WEDNESDAY, Sept. 23, 2026 (HealthDay News) — Generalized pustular psoriasis (GPP) is associated with elevated mortality and comorbidity risk compared with psoriasis vulgaris (PV) and nonpsoriatic controls, according to a study published online Sept. 2 in Frontiers in Immunology.

Teng-Li Lin, M.D., from Dalin Tzu Chi Hospital in Chiayi, Taiwan, and colleagues compared mortality and major comorbidities in individuals with GPP and PV and nonpsoriatic individuals. Patients with GPP were propensity score-matched to those with PV and nonpsoriatic controls by age, sex, and race in a 1:1 ratio. Among patients with GPP, separate matching was performed for those receiving biologics, conventional antipsoriatic drugs, or small molecule inhibitors versus those receiving systemic corticosteroids alone.

Overall, 6,959 GPP-PV and 28,459 GPP-nonpsoriatic pairs were analyzed after matching. The researchers found that patients with GPP had higher five-year mortality than those with PV and nonpsoriatic controls over five years (hazard ratios, 1.83 and 2.42, respectively). Compared with patients with PV, patients with GPP had higher major comorbidity risks, including ischemic heart disease, cerebrovascular disease, and neurodegenerative disease (hazard ratios, 1.34, 1.62, and 2.94, respectively); compared with nonpsoriatic controls, elevated risks were seen across all evaluated comorbidities. Patients older than 60 years and men had particularly pronounced mortality risks. Biologic therapy was associated with lower mortality than systemic corticosteroids alone among patients with GPP (hazard ratio, 0.71), while conventional antipsoriatic drugs and small-molecule inhibitors were not.

“Together, these findings provide additional real-world evidence on the long-term mortality burden, associated disease risks, and treatment-related outcomes of GPP, addressing important gaps in current evidence for this rare disease,” the authors write.

Abstract/Full Text