Generalizovana Pustulozna Psorijaza Sa Sistemskom Inflamacijom I Prolaznom Hepatičnom Disfunkcijom – Prikaz Slučaja

Miloš Divjak; Dragana Sokolović; Milica Radanović; Dijana Milanović Divjak; Dragana Drakul

doi:10.2478/sjdv-2025-0009

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Generalizovana Pustulozna Psorijaza Sa Sistemskom Inflamacijom I Prolaznom Hepatičnom Disfunkcijom – Prikaz Slučaja

Serbian Journal of Dermatology and Venereology

Volume 14 (2025): Issue 2 (December 2025)

By: Miloš Divjak, Dragana Sokolović, Milica Radanović, Dijana Milanović Divjak and Dragana Drakul

Open Access

|May 2026

Abstract

Uvod. Generalizovana pustulozna psorijaza je redak, težak i potencijalno životnougrožavajući oblik psorijaze, često praćen izraženom sistemskom inflamacijom i razvojem eritrodermije. Poremećaji funkcije jetre tokom lečenja generalizovane pustulozne psorijaze predstavljaju značajan dijagnostički i terapijski izazov.

Prikaz slučaja. Bolesnik star 69 godina hospitalizovan je zbog eritematoznih plakova sa sterilnim pustulama na trupu, ekstremitetima, šakama, stopalima i razvojem eritrodermije, sistemske inflamacije i prolaznom hepatičnom disfunkcijom. Tokom lečenja acitretinom i antibioticima zabeležen je značajan porast jetrenih enzima i holestaznih parametara, uz uredan radiološki nalaz jetre i negativne virusološke analize. Privremena obustava potencijalno hepatotoksičnih lekova i korekcija terapije doveli su do normalizacije laboratorijskih parametara i kliničkog poboljšanja.

Zaključak. Ovaj prikaz naglašava značaj pažljivog laboratorijskog i kliničkog praćenja, kao i individualizovanog terapijskog pristupa kod bolesnika sa generalizovanom pustuloznom psorijazom u prisustvu sistemskih komplikacija.

References

Bhutani T, Farberg AS. Clinical and disease burden of patients with generalized pustular psoriasis: a review of real-world evidence. Dermatol Ther (Heidelb). 2024; 14(2):341-60.
Search in Google Scholar Back to article
Romiti R, Hirayama ALDS, Arnone M, Magalhães RF. Generalized pustular psoriasis (von Zumbusch). An Bras Dermatol. 2022;97(1):63-74.
Search in Google Scholar Back to article
Lee CC, Huang YH, Chi CC, Chung WH, Chen CB. Generalized pustular psoriasis: immunological mechanisms, genetics, and emerging therapeutics. Trends Immunol. 2025;46(1):74-89.
Search in Google Scholar Back to article
Aizu T, Matsui A, Takiyoshi N, Akasaka E, Kaneko T, Nakano H, et al. Elderly-onset generalized pustular psoriasis without a previous history of psoriasis vulgaris. Case Rep Dermatol. 2015;7(2):187-93.
Search in Google Scholar Back to article
Rivera-Díaz R, Daudén E, Carrascosa JM, Cueva P, Puig L. Generalized pustular psoriasis: a review on clinical characteristics, diagnosis, and treatment. Dermatol Ther (Heidelb). 2023;13(3):673-88.
Search in Google Scholar Back to article
Fujita H, Gooderham M, Romiti R. Diagnosis of generalized pustular psoriasis. Am J Clin Dermatol. 2022;23(Suppl 1):31-8.
Search in Google Scholar Back to article
Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009;61(3):451-85.
Search in Google Scholar Back to article
Bachelez H, Barker J, Burden AD, Navarini AA, Krueger JG. Generalized pustular psoriasis is a disease distinct from psoriasis vulgaris: evidence and expert opinion. Expert Rev Clin Immunol. 2022;18(10):1033-47.
Search in Google Scholar Back to article
Navarini AA, Burden AD, Capon F, Mrowietz U, Puig L, Köks S, et al. European consensus statement on phenotypes of pustular psoriasis. J Eur Acad Dermatol Venereol. 2017;31(11):1792-9.
Search in Google Scholar Back to article
Sidoroff A, Halevy S, Bavinck JN, Vaillant L, Roujeau JC. Acute generalized exanthematous pustulosis (AGEP)-a clinical reaction pattern. J Cutan Pathol. 2001;28(3):113-9.
Search in Google Scholar Back to article
Ellis J, Lew J, Brahmbhatt S, Gordon S, Denunzio T. Erythrodermic psoriasis causing uric acid crystal nephropathy. Case Rep Med. 2019;2019:8165808.
Search in Google Scholar Back to article
Johnston A, Xing X, Wolterink L, Barnes DH, Yin Z, Reingold L, et al. IL-1 and IL-36 are dominant cytokines in generalized pustular psoriasis. J Allergy Clin Immunol. 2017;140(1):109-20.
Search in Google Scholar Back to article
Teshima R, Saito-Sasaki N, Sawada Y. Generalized pustular psoriasis and systemic organ dysfunctions. Int J Mol Sci. 2024;25(11):6270.
Search in Google Scholar Back to article

Articles in this issue

DOI: https://doi.org/10.2478/sjdv-2025-0009 | Journal eISSN: 2406-0631 | Journal ISSN: 1821-0902

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Language: English

Page range: 67 - 75

Submitted on: Feb 13, 2026

Accepted on: Mar 18, 2026

Published on: May 12, 2026

Published by: Serbian Association of Dermatovenereologists (SAD)

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

psorijaza,

vezikulobulozne dermatoze,

sindrom sistemskog inflamatornog odgovora,

jetra,

enzimi,

eksfolijativni dermatitis,

acitretin,

oštećenje jetre izazvano lekovima i hemikalijama,

citokini

Related subjects:

Medicine,

Clinical medicine,

Dermatological and veneral diseases

© 2026 Miloš Divjak, Dragana Sokolović, Milica Radanović, Dijana Milanović Divjak, Dragana Drakul, published by Serbian Association of Dermatovenereologists (SAD)
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 14 (2025): Issue 2 (December 2025)