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Tips on Addressing Generalized Pustular Psoriasis, With Raj Chovatiya, MD, PhD
In his Fall Clinical interview, Chovatiya highlights several key takeaways from his talk on generalized pustular psoriasis (GPP) management.
At the 2025 Fall Clinical Dermatology Conference in Las Vegas, Nevada, Raj Chovatiya, MD, PhD, co-presented a session titled ‘Seminar-in-Depth: Shifting the Management Paradigm in Generalized Pustular Psoriasis.’1
Chovatiya, who currently serves as both clinical associate professor at Rosalind Franklin University Chicago Medical School and director of the Center for Medical Dermatology and Immunology Research, spoke with the team at HCPLive on his portion of this session. Chovatiya highlighted several key points about managing generalized pustular psoriasis (GPP).
“Generalized pustular psoriasis is a pretty rare disease in the dermatology space,” Chovatiya explained. “It's not something that you're going to see perhaps that often in your career, but when you do, it can really be a emergency, from dermatologic perspective. We don't have that many dermatologic conditions where I truly use that word emergency.”
Among patients with GPP, Chovatiya noted, there is a major burden in terms of uncertainty about the course of this skin disease as well as potential for the inpatient hospitalization route, the emergency care route, and even mortality. Chovatiya noted that it is important to know how to diagnose GPP.
“You don't have to have chronic plaque psoriasis to have generalized pustular psoriasis,” Chovatiya said. “It really is a diagnosis that you can make clinically based on the presence of innumerable pustular lesions, usually on an erythematous base on the skin. Typically, there's an onset of symptoms that's highly rapid. There's often a lot of pain…or discomfort that patients experience. And systemic symptoms are another thing that oftentimes accompany this disease, in terms of fever, myalgia, and chills that you just don't see with chronic plaque psoriasis.”
Chovatiya later highlighted GPP’s more homogenous pathway of immunology than had once been thought.2
“A lot of the disease itself is mediated by IL-36 and neutrophilic inflammation that is related to IL-36,” Chovatiya said. “it's a very cool story in medicine, how we discovered this as really, once upon a time, it was actually cohorts of consanguineous patients that had similar mutations in this pathway that had a phenotype that we now call GPP. So that's where part three of the talk comes in…where we learned that, actually, blockade of IL-36 signaling can make a huge difference in patients.”
For any additional information on Chovatiya’s talk held at the Fall Clinical Conference, view more by watching his video posted above.
Chovatiya previously reported serving as an advisor, consultant, speaker, and/or investigator for AbbVie, Amgen, Apogee Therapeutics, Arcutis, Argenx, ASLAN Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, Eli Lilly and Company, FIDE, Formation Bio, Galderma, Genentech, GSK, Incyte, LEO Pharma, L’Oréal, Nektar Therapeutics, Novartis, Opsidio, Pfizer Inc., Regeneron, RAPT, Sanofi, Sitryx, and UCB.
References
Chovatiya R, Elewski B. Seminar-in-Depth: Shifting the Management Paradigm in Generalized Pustular Psoriasis. Session presentation at the 2025 Fall Clinical Dermatology Conference, Las Vegas, Nevada, Oct 23-26, 2025.
Hawkes JE, Visvanathan S, Krueger JG. The role of the interleukin-36 axis in generalized pustular psoriasis: a review of the mechanism of action of spesolimab. Front Immunol. 2023 Nov 21;14:1292941. doi: 10.3389/fimmu.2023.1292941. PMID: 38077370; PMCID: PMC10703363.
