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GPP Flares

RECOGNISING GPP FLARES

WHAT IS A GPP FLARE?

Generalized Pustular Psoriasis (GPP) flares are characterised by eruptions of painful, sterile pustules.1

WHAT TRIGGERS GPP FLARES?

Recognising the triggers of flares early may help in managing your patient's disease. GPP flares can be triggered by

Sunlight

SUNLIGHT2

Pregnancy

PREGNANCY2

Certain medication

CERTAIN MEDICATIONS and SUDDEN WITHDRAWAL OF STEROIDS3

Stress

STRESS2

Infection

INFECTION2

HOW GPP FLARES CAN MANIFEST ON SKIN4

The symptoms of GPP most cited by dermatologists include pustules and worsening lesions.3

GPP Pustules
GPP Pustules

OTHER FLARE SYMPTOMS MAY INCLUDE:

Itching

ITCHING5

Scaling

SCALING3

Dryness

DRYNESS5

ERYTHEMA

ERYTHEMA3

Pain

PAIN3

Reddness

REDDNESS5

Burning-sensation

BURNING SENSATION5

Discomfort

DISCOMFORT5

Fever

FEVER3

INFLAMMATORY MARKERS

INFLAMMATORY
MARKERS3

Fatigue

FATIGUE5

ANXIETY

ANXIETY5

THE CLINICAL COURSE OF GPP FLARES IS UNPREDICTABLE

GPP is heterogenous. Flare symptoms and triggers can vary and even present differently within the same patient.6 Previous GPP flare episodes do not indicate the severity or duration of the next flare.3

THE GPPGA SCORE CAN BE USED FOR ASSESSING FLARES7 

The GPPGA is a scoring tool that can be used to assess the severity of flare symptoms. It was created by modifying the PGA, a clinical tool used by dermatologists to assess psoriasis.3

GPPGA Scoring Tool Guide

All images ©2021 Boehringer Ingelheim International, GmbH. All rights reserved.

TO DETERMINE A PATIENT’S GPPGA SCORE7:

Assess the pustules, erythema, and scaling skin

1.

ASSESS THE PUSTULES, ERYTHEMA, AND SCALING SKIN

Grade each individual component

2.

GRADE EACH INDIVIDUAL COMPONENT

Calculate the average to determine the composite score

3.

CALCULATE THE AVERAGE TO DETERMINE THE COMPOSITE SCORE

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LEARN ABOUT THE IMPACT OF GPP ON PATIENTS

Find out more

GPP= Generalized pustular psoriasis; GPPGA=Generalized Pustular Psoriasis Physician Global Assessment; PGA=Physician Global Assessment.

REFERENCES

  1. Zheng M, Jullien D, Eyerich K. The Prevalence and Disease Characteristics of Generalized Pustular Psoriasis. Am J Clin Dermatol. 2022;23(Suppl 1):5-12.

  2. Mohd Affandi A, Khan I, Ngah Saaya N. Epidemiology and Clinical Features of Adult Patients with Psoriasis in Malaysia: 10-Year Review from the Malaysian Psoriasis Registry (2007-2016). Dermatol Res Pract. 2018;2018:4371471.

  3. Strober B, Kotowsky N, Medeiros R, et al. Unmet Medical Needs in the Treatment and Management of Generalized Pustular Psoriasis Flares: Evidence from a Survey of Corrona Registry Dermatologists. Dermatol Ther (Heidelb). 2021;11(2):529-541.

  4. Marrakchi S, Guigue P, Renshaw BR, et al. Interleukin-36-receptor antagonist deficiency and generalized pustular psoriasis. N Engl J Med. 2011;365(7):620-628.

  5. Burden AD, Mrowietz U, Skalicky AM, et al. Symptom Experience and Content Validity of the Psoriasis Symptom Scale (PSS) in Patients with Generalized Pustular Psoriasis (GPP). Dermatol Ther (Heidelb). 2022;12(6):1367-1381.

  6. Choon SE, Lebwohl MG, Marrakchi S, et al. Study protocol of the global Effisayil 1 Phase II, multicentre, randomised, double-blind, placebo-controlled trial of spesolimab in patients with generalized pustular psoriasis presenting with an acute flare. BMJ Open. 2021;11(3):e043666.

  7. Burden AD, Choon SE, Gottlieb AB, Navarini AA, Warren RB. Clinical Disease Measures in Generalized Pustular Psoriasis. Am J Clin Dermatol. 2022;23:39-50.

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