Multistage diagnostic dilemmas in de novo generalized pustular psoriasis- A case report and review of literature

Generalized pustular psoriasis (GPP) is a rare variant of pustular psoriasis characterized by the generalized appearance of pustules over erythematous skin along with systemic constitutional symptoms in the form of fever, fatigue, weakness, and body aches. Infections, hormonal changes, intake or withdrawal of certain drugs, and stress are known to trigger this condition in the majority of cases, along with genetic factors. The outcome of GPP depends upon the extent of body involvement, the severity of the disease, and complications. We are here reporting a case of GPP having a diagnostic dilemma initially with Drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthemata’s pustulosis (AGEP), IgA pemphigus, and later with complications of GPP and sepsis.