{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:41:37Z","timestamp":1773769297248,"version":"3.50.1"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Generalized pustular psoriasis (GPP) is a rare, potentially life-threatening inflammatory disease characterized by neutrophilic pustules and systemic inflammation. We report a case of severe GPP triggered by SARS-CoV-2 infection in a 46-year-old woman with a long history of psoriasis. Eleven days after recovery from COVID-19 pneumonia, she developed widespread pustules and fever. Histopathology revealed subcorneal spongiform pustules and dermal neutrophilic infiltration consistent with GPP. Systemic corticosteroids followed by etretinate and deucravacitinib achieved complete remission. A literature review identified 11 infection- and 10 vaccine-related GPP cases. Compared with vaccine-associated cases, infection-related flares showed longer latency and higher corticosteroid use. Mechanistically, both SARS-CoV-2 infection and vaccination may be associated with IL-36 axis activation, potentially via spike protein\u2013driven, Toll-like receptor\u2013mediated innate immune signaling. This case highlights that distinct immune kinetics may underlie infection- and vaccine-related GPP, while supporting a putative role of IL-36\u2013driven inflammation in COVID-19\u2013associated disease exacerbation.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1740000","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:37:59Z","timestamp":1773758279000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pustular psoriasis flare following COVID-19 infection: a case report and literature review"],"prefix":"10.3389","volume":"17","author":[{"given":"Eri","family":"Ohta","sequence":"first","affiliation":[{"name":"Department of Dermatology, Takasaki General Medical Center","place":["Takasaki, Japan"]},{"name":"Department of Dermatology, University of Occupational and Environmental Health","place":["Kitakyushu, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etsuko","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Takasaki General Medical Center","place":["Takasaki, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Occupational and Environmental Health","place":["Kitakyushu, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-021-00677-8","article-title":"Role of interleukin 36 in generalised pustular psoriasis and beyond","volume":"12","author":"Sugiura","year":"2022","journal-title":"Dermatol Ther (Heidelb)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14949","article-title":"Generalized pustular psoriasis: a review and update 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