{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:20:02Z","timestamp":1792002002316,"version":"4.4.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Association of Dermatology and Venereology"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pustular psoriasis (PP) comprises a group of rare autoinflammatory skin diseases characterized by sterile pustules. Previous studies have focused on cohorts in East Asia and the West, while North African populations have been underrepresented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the demographic and clinical features of a large cohort of European and Egyptian patients with PP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected data on 504 patients with PP from 13 centres across Egypt and 5 European countries (Estonia, Germany, Spain, Switzerland and the UK); we then analysed their demographic profiles, clinical presentations and treatment histories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 504 patients with PP (424 Europeans and 80 Egyptians), 78 (15.5%) had generalized pustular psoriasis (GPP), 374 (74.2%) had palmoplantar pustulosis (PPP), 12 (2.4%) had acrodermatitis continua of Hallopeau (ACH) and 40 (7.9%) had other or overlapping PP subtypes. PPP was more prevalent among Europeans than among Egyptians (83% vs. 28%), whereas GPP was more prevalent among Egyptians than among Europeans (60% vs. 7%). Europeans included more women than men (80% vs. 40% with GPP, and 79% vs. 23% with PPP; both P &amp;lt; 0.001). The mean age (SD) of European patients was significantly higher than that of Egyptian patients [59.9 (16.8) vs. 36.1 (18.6) years with GPP and 62.2 (16.4) vs. 40.2 (13.8) years with PPP; both P &amp;lt; 0.001]. European patients with GPP had higher rates of psoriasis vulgaris (PV) than Egyptian patients with GPP (29% vs. 10%; P = 0.043). Treatment patterns varied, with ciclosporin being frequently used in Europe, while treatment with methotrexate and steroids was more common in Egypt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlights significant variations between European and Egyptian patients with PP. European patients more commonly presented with PPP, whereas Egyptian patients had a higher incidence of GPP and fewer diagnoses of comorbid PV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ced\/llaf534","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:50:36Z","timestamp":1765889436000},"page":"1046-1053","source":"Crossref","is-referenced-by-count":2,"title":["Clinical phenotypes of 504 patients with pustular psoriasis from Europe and Egypt: a multicentre observational study"],"prefix":"10.1093","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1866-3166","authenticated-orcid":false,"given":"Alshimaa","family":"Mostafa","sequence":"first","affiliation":[{"name":"Department of Dermatology, University Hospital Zurich , Zurich ,","place":["Switzerland"]},{"name":"Department of Dermatology, Graduate School of Medicine, Kyoto University , Kyoto ,","place":["Japan"]},{"name":"Department of Dermatology, Faculty of Medicine, Beni-Suef University , Beni-Suef ,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3335-2243","authenticated-orcid":false,"given":"Ahmed","family":"Arafa","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Medicine, Beni-Suef University , Beni-Suef ,","place":["Egypt"]},{"name":"Department of Preventive Cardiology, National Cerebral and Cardiovascular Center , Suita ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Gohary","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Beni-Suef University , Beni-Suef ,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Anzengruber","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Zurich , Zurich ,","place":["Switzerland"]},{"name":"Faculty of Medicine, University of Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"El-Komy","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Cairo University , Cairo ,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rania","family":"Abdel Hay","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Cairo University , Cairo ,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4916-2778","authenticated-orcid":false,"given":"Amira A","family":"Eid","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology, and Andrology, Faculty of Medicine, Alexandria University , Alexandria ,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Burri","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Capon","sequence":"additional","affiliation":[{"name":"St John\u2019s Institute of Dermatology, Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, King\u2019s College London , London ,","place":["UK"]},{"name":"Department of Medical Genetics and Centre for Molecular Medicine and Therapeutics, University of British Columbia , Vancouver, BC ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Barker","sequence":"additional","affiliation":[{"name":"St John\u2019s Institute of Dermatology, Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, King\u2019s College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9914-1545","authenticated-orcid":false,"given":"Julia-Tatjana","family":"Maul","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Zurich , Zurich ,","place":["Switzerland"]},{"name":"Faculty of Medicine, University of Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7059-632X","authenticated-orcid":false,"given":"Alexander A","family":"Navarini","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Basel , Basel ,","place":["Switzerland"]},{"name":"Faculty of Medicine, University of Basel , Basel 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