{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:16:06Z","timestamp":1792790166328,"version":"4.5.0"},"reference-count":47,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2019s Horizon 2020 Research and Innovation Program","award":["848028"],"award-info":[{"award-number":["848028"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Generalized pustular psoriasis (GPP) is a rare, severe inflammatory skin disease characterized by recurrent episodes of flares. Characteristics of patients experiencing a flare are hardly described in a real-life setting. The aim of the study is to investigate the clinical characteristics of patients experiencing a flare of GPP. Methods: Multicenter retrospective observational study on consecutive patients experiencing a flare of GPP between 2018 and 2022. Disease severity and quality of life were assessed by Generalized Pustular Psoriasis Area, Body Surface Area (BSA), and Severity Index (GPPASI), and Dermatology life quality index (DLQI) questionnaire, respectively. Visual analogue scale (VAS) of itch and pain, triggers, complications, comorbidities, pharmacological therapies, and outcome were collected. Results: A total of 66 patients, 45 (68.2%) females, mean age 58.1 \u00b1 14.9 years, were included. The GPPASI, BSA, and DLQI were 22.9 \u00b1 13.5 (mean \u00b1 standard deviation), 47.9 \u00b1 29.1, and 21.0 \u00b1 5.0, respectively. The VAS of itch and pain were 6.2 \u00b1 3.3 and 6.2 \u00b1 3.0, respectively. Fever (&gt;38 \u00b0C) and leukocytosis (WBC &gt; 12 \u00d7 109\/L) were found in 26 (39.4%) and 39 (59.1%) patients, respectively. Precipitating triggers were identified in 24 (36.3%) and included infections (15.9%), drugs (10.6%), stressful life events (7.6%), and corticosteroids withdrawal (3.0%). Fourteen (21.2%) patients were hospitalized because of complications including infections in 9 (13.6%) leading to death in one case and hepatitis in 3 (4.5%). Conclusions: GPP flares can be severe and cause severe pain and itch with significant impact on the quality of life. In about one-third of patients the flare may have a persistent course and, with complications, lead to hospitalization.<\/jats:p>","DOI":"10.3390\/vaccines11040740","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T06:46:19Z","timestamp":1679899579000},"page":"740","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Characteristics of Patients Experiencing a Flare of Generalized Pustular Psoriasis: A Multicenter Observational Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Francesco","family":"Bellinato","sequence":"first","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1777-9001","authenticated-orcid":false,"given":"Paolo","family":"Gisondi","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8160-4169","authenticated-orcid":false,"given":"Angelo","family":"Marzano","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1091-4733","authenticated-orcid":false,"given":"Stefano","family":"Piaserico","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medicine, University of Padua, 35122 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"De Simone","sequence":"additional","affiliation":[{"name":"Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Dermatologia, Dipartimento Universitario Di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica Del Sacro Cuore, 20123 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2390-6505","authenticated-orcid":false,"given":"Giovanni","family":"Damiani","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20126 Milan, Italy"},{"name":"Unit of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1413-8214","authenticated-orcid":false,"given":"Giuseppe","family":"Argenziano","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Universit\u00e0 Degli Studi Della Campania L. Vanvitelli, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-3695","authenticated-orcid":false,"given":"Marina","family":"Venturini","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Brescia at ASST-Spedali Civili, 25121 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Dapavo","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medical Sciences, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy"},{"name":"Humanitas Clinical and Research Center, Scientific Institute for Research, Hospitalization and Healthcare, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1803-2046","authenticated-orcid":false,"given":"Matteo","family":"Megna","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5997-2045","authenticated-orcid":false,"given":"Francesca","family":"Prignano","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Health Sciences, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4381-6718","authenticated-orcid":false,"given":"Martina","family":"Burlando","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dipartimento Della Salute-DiSSal, University of Genoa, 16126 Genoa, Italy"},{"name":"IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Satolli","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medicine and Surgery, University of Parma, 43100 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8231-2205","authenticated-orcid":false,"given":"Andrea","family":"Carugno","sequence":"additional","affiliation":[{"name":"Dermatology Unit, ASST Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy"},{"name":"Ph.D. Program in Molecular and Translational Medicine (DIMET), University of Milan-Bicocca, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0121-4812","authenticated-orcid":false,"given":"Elena","family":"Pezzolo","sequence":"additional","affiliation":[{"name":"Dermatology Unit, San Bortolo Hospital, 36100 Vicenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Romanelli","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Pisa, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Cuccia","sequence":"additional","affiliation":[{"name":"Unit of Dermatology, San Donato Hospital, 52100 Arezzo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8548-0493","authenticated-orcid":false,"given":"Giampiero","family":"Girolomoni","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. 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