{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T06:55:50Z","timestamp":1768546550234,"version":"3.49.0"},"reference-count":8,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T00:00:00Z","timestamp":1543190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Generalized pustular psoriasis (<jats:styled-content style=\"fixed-case\">GPP<\/jats:styled-content>) is a systemic inflammatory disease that presents with erythema and sterile pustules, pathologically characterized by Kogoj's spongiform pustules. <jats:styled-content style=\"fixed-case\">GPP<\/jats:styled-content> is sometimes accompanied by mucosal involvement, and the most common lesion is on the tongue. <jats:italic><jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>36<jats:styled-content style=\"fixed-case\">RN<\/jats:styled-content><\/jats:italic> mutation was found to contribute to the pathogenesis of <jats:styled-content style=\"fixed-case\">GPP<\/jats:styled-content> especially in patients who develop <jats:styled-content style=\"fixed-case\">GPP<\/jats:styled-content> without a past medical history of psoriasis vulgaris. The association of <jats:italic><jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>36<jats:styled-content style=\"fixed-case\">RN<\/jats:styled-content><\/jats:italic> mutation with mucosal involvement in <jats:styled-content style=\"fixed-case\">GPP<\/jats:styled-content> is controversial. We herein report a 60\u2010year\u2010old male <jats:styled-content style=\"fixed-case\">GPP<\/jats:styled-content> patient with no past history of plaque psoriasis presenting with not only severe skin lesions and arthritis but also severe mucosal involvements of pharyngeal and gastrointestinal lesions, which led to gastrointestinal bleeding. Our case did not have any mutation in the <jats:italic><jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>36<jats:styled-content style=\"fixed-case\">RN<\/jats:styled-content><\/jats:italic> gene. We should be aware that severe <jats:styled-content style=\"fixed-case\">GPP<\/jats:styled-content> can cause gastrointestinal bleeding. The relevancy of <jats:italic><jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>36<jats:styled-content style=\"fixed-case\">RN<\/jats:styled-content><\/jats:italic> mutation with mucosal involvement in <jats:styled-content style=\"fixed-case\">GPP<\/jats:styled-content> remains to be elucidated.<\/jats:p>","DOI":"10.1111\/1346-8138.14711","type":"journal-article","created":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T11:25:37Z","timestamp":1543231537000},"page":"73-75","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Gastrointestinal bleeding with severe mucosal involvement in a patient with generalized pustular psoriasis without <i><scp>IL<\/scp>36<scp>RN<\/scp><\/i> mutation"],"prefix":"10.1111","volume":"46","author":[{"given":"Shiori","family":"Komatsuda","sequence":"first","affiliation":[{"name":"Departments of Dermatology Teikyo University School of Medicine Tokyo 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