Diagnosing and Managing Pustular Psoriasis: A Rare But Serious Disease - POCN

Diagnosing and Managing Pustular Psoriasis: A Rare But Serious Disease

Primary Care | July 12, 2021


1.0 CME Credit 1 ABIM MOC Point
Start Course

Launch Date:

July 12, 2021

Expiration Date:

July 12, 2022

primary audience:

Clinicians who may diagnose and manage patients with pustular psoriasis, Primary care physicians

Relevant Terms:

Generalized pustular psoriasis, Palmoplantar pustulosis, Pustular psoriasis, Pustulosis

course information


Pustular psoriasis is a group of rare psoriasis subtypes typified by aseptic, neutrophil-rich pustules. The three most common types are generalized pustular psoriasis, palmoplantar pustular psoriasis, and acrodermatitis continua of Hallopeau. The diagnosis of pustular psoriasis relies primarily on clinical features and may be difficult. Recent guidelines on diagnosis, classification, and assessment of severity have been published by ERASPEN and by the Japanese Dermatological Association.

Treatment of pustular psoriasis involves systemic therapy with cyclosporine, methotrexate or acitretin. Guidelines and a treatment algorithm have been published by the Japanese Dermatological Association. The understanding that IL-36 cytokines are likely the key driver of the autoimmune response in pustular psoriasis has led to the development of two novel, investigational monoclonal antibodies that target the IL-36 receptor. In addition, agents that target other molecules have also been investigated.

Diagnosing and Managing Pustular Psoriasis: A Rare But Serious Disease will provide clinicians with information about the most recent guidelines for diagnosing, classifying, and assessing the severity of pustular psoriasis. Current treatment guidelines and a review of agents in development will help clinicians manage this rare group of disorders.


Welcome and Introduction
Diagnosing and Assessing Severity of Pustular Psoriasis
Managing Pustular Psoriasis
Q&A Session and Activity Roundup


M. Susan Burke, MD, FACP
Clinical Associate Professor of Medicine
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, PA
Senior Advisor, Lankenau Medical Associates
Lankenau Medical Center
Wynnewood, PA

M. Susan Burke, MD, FACP is Clinical Associate Professor of Medicine at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, PA; an Adjunct Associate Professor of Geriatrics at the Philadelphia College of Osteopathic Medicine in Philadelphia; and Senior Advisor of Lankenau Medical Associates at the Lankenau Medical Center in Wynnewood, PA, where she has been a clinician and teaching attending for more than 30 years. Having earned her medical degree from the University of Pennsylvania Perelman School of Medicine (Philadelphia), she completed a residency in internal medicine at Lankenau Hospital (now the Lankenau Medical Center). Dr. Burke is board-certified in internal medicine and geriatrics and is a Fellow of the American College of Physicians.

A two-time recipient of the Osler-Blockley Award for Excellence in Clinical Teaching from Thomas Jefferson University, Dr. Burke also has received the Residents’ Award for Best Teacher from the Lankenau Internal Medicine house staff. She has been named a Best Doctor for Women and, more recently, a Top Doctor by Main Line Today magazine. Dr. Burke lectures nationally and has published chapters and articles on numerous primary care and geriatric topics on CME websites, as well as in publications such as the Journal of the American Osteopathic Association and Annals of Long-Term Care.

Ahuva Cices, MD
Dermatology Resident
Icahn School of Medicine at Mount Sinai
New York, NY

Ahuva Cices, MD is a second year dermatology resident at the Icahn School of Medicine at Mount Sinai. As a medical student at the State University of New York (SUNY) Downstate she was inducted into the AOA Honor Medical Society. After graduating from medical school, she completed an internship in Internal Medicine at the Mount Sinai Hospital. Having dedicated three years to clinical research in dermatology prior to starting residency, Ahuva has extensive experience conducting clinical trials in a wide array of conditions including psoriasis, pediatric and adult atopic dermatitis, cutaneous T-cell lymphoma, prurigo nodularis, and acne. Her clinical and research interests include immune-mediated inflammatory skin disorders, skin of color, and cutaneous T-cell lymphoma.

Mark Lebwohl, MD
Dean for Clinical Therapeutics
Chairman Emeritus of the Kimberly and Eric J. Waldman Department of Dermatology
Icahn School of Medicine at Mount Sinai
New York, NY

Mark Lebwohl, MD Dr. Mark Lebwohl is Dean for Clinical Therapeutics and Chairman Emeritus of the Kimberly and Eric J. Waldman Department of Dermatology at the Icahn School of Medicine at Mount Sinai. He is a past President of the American Academy of Dermatology and Chairman emeritus of the medical Board of the National Psoriasis Foundation.

He received his degree in medicine from Harvard Medical School in Boston, Massachusetts, USA, and completed his internship and residency in internal medicine, as well as his residency in dermatology at Mount Sinai Hospital in New York.

His key interests in clinical research include skin cancer and inflammatory skin diseases including psoriasis, atopic dermatitis, vitiligo and alopecia areata. Dr Lebwohl identified one of the first topical therapies approved for skin cancer and precancerous lesions. In addition, many of the systemic and topical therapies for psoriasis and atopic dermatitis were investigated or developed in the Department of Dermatology at Mount Sinai. Dr. Lebwohl has authored or coauthored nearly 500 original peer-reviewed original reports, 400 invited articles and other publications and approximately 250 abstracts. Notably, he is the author of the first atlas, Atlas of the Skin of Systemic Disease, which is dedicated to cutaneous manifestations of systemic disease and coeditor of Treatment of Skin Disease, a leading textbook in dermatology that has been translated into several languages, won several medical book awards, and is in its 5th edition.

Dr Lebwohl is the founding editor of the Journal of Psoriasis and Psoriatic Arthritis and of Skin, the Journal of Cutaneous Medicine. He has served on the editorial boards of the Journal of the European Academy of Dermato-Venereology, the Latin American Journal of Psoriasis and Psoriatic Arthritis, the Journal of Skin Cancer and the Journal of the American Academy of Dermatology. Currently, he is editor of the dermatology section of Scientific American Medicine. In addition, as a renowned expert in dermatology, Dr. Lebwohl is frequently an invited visiting professor and speaker at universities, medical centers, and conferences and symposia worldwide.

Active in a number of professional organizations, Dr Lebwohl is an honorary member of the French Society of Dermatology and the Canadian Dermatology Association. He is past president of the American Academy of Dermatology and Chairman Emeritus of the Medical Board of the National Psoriasis Foundation. Dr. Lebwohl serves on the International Psoriasis Council.

Throughout his distinguished career, Dr Lebwohl has been the recipient of many awards, such as the Presidential Citation from the American Academy of Dermatology for his service to the AAD on psoriasis and for his work with the Psoriasis Foundation. Furthermore, he has received Lifetime Achievement Awards from the National Psoriasis Foundation and American Skin Association and has been recognized as a Leader of Distinction by the Journal of Drugs in Dermatology for his work in psoriasis. In addition, Dr Lebwohl was the honorary chairman of the 1st World Psoriasis and Psoriatic Arthritis Conference held in Stockholm, Sweden in 2006 by the International Federation of Psoriasis Associations and its patron, His Majesty King Carl Gustav of Sweden.


The intended audience for this educational initiative is primary care physicians and other clinicians who may diagnose and manage patients with pustular psoriasis.


At the conclusion of this education, participants should be able to:

  • Describe the pathophysiology of pustular psoriasis and how it is different from that of plaque psoriasis
  • Use current guidelines to diagnose and classify pustular psoriasis
  • Employ current guidelines when managing patients with pustular psoriasis
  • Assess the mechanism of action, efficacy, and safety of agents in development for managing pustular psoriasis


This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Potomac Center for Medical Education and Rockpointe. The Potomac Center for Medical Education is accredited by the ACCME to provide continuing medical education for physicians.


The Potomac Center for Medical Education designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. For information about the accreditation of this program, please email: contact@potomacme.org.

ABIM MOC RECOGNITION STATEMENT Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

To receive CME credit and/or MOC points, you MUST pass the post-test and complete the evaluation. For ABIM MOC points, your information will be shared with the ABIM through PCME’s ACCME Program and Activity Reporting System (PARS). Please allow 6-8 weeks for your MOC points to appear on your ABIM records.

AMERICAN BOARD OF DERMATOLOGY MOC INFORMATION Dermatologists certified by the American Board of Dermatology (ABD) must earn a minimum of 25 hours of AMA PRA Category 1 Credits™ annually. Half of these credits must be Dermatology practice-specific CME credits from accredited organizations in order to fulfill the lifelong learning component of MOC. Participation in this activity will support board certified dermatologists in contributing towards this MOC requirement set forth by the ABD.

MOC APPROVAL STATEMENT Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, “Diagnosing and Managing Pustular Psoriasis: A Rare But Serious Disease” has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:

MOC Part II CME Activity

Family Medicine


The Potomac Center for Medical Education (PCME) adheres to the policies and guidelines, including the Standards for Commercial Support, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous.

All persons in a position to control the content of a continuing medical education program provided by PCME are required to disclose any relevant financial relationships with any commercial interest to PCME as well as to learners. All conflicts of interest are identified and resolved by PCME in accordance with the Standards for Commercial Support in advance of delivery of the activity to learners.

Program Faculty

The faculty, authors and content developers reported the following relevant financial relationships that they have with commercial interests:

M. Susan Burke, MD, FACP: Speaker’s Bureau: Merck and Co, Inc.

Ahuva Cices, MD: Nothing to disclose

Mark Lebwohl, MD Grant/Research Support: AbbVie, Amgen, Arcutis, Avotres, Boehringer Ingelheim, Dermavant Sciences, Eli Lilly, Incyte, Janssen Research & Development, LLC, Ortho Dermatologics, Regeneron, and UCB, Inc.; Consultant/Independent Contractor: Aditum Bio, Almirall, AnaptysBio, Arcutis, Inc., Aristea Therapeutics, Arrive Technologies, Avotres Therapeutics, BiomX, Boehringer-Ingelheim, Bristol-Myers Squibb, Cara Therapeutics, Castle Biosciences, Corrona, Dermavant Sciences, Dr. Reddy’s Laboratories, Evelo Biosciences, Evommune, Inc., Facilitatation of International Dermatology Education, Forte Biosciences, Helsinn Therapeutics, LEO Pharma, Meiji Seika Pharma, Mindera, Pfizer, Verrica; Speaker’s Bureau: Aimmune

Planners and Managers

The planners and mangers reported the following relevant financial relationships that they have with commercial interests:

Chad Williamson, MS, MBA, CMPP: Nothing to disclose

Content Reviewers

The content reviewers reported the following relevant financial relationships that they have with commercial interests:

Katie Propst, PhD: Nothing to disclose


The contents of some CME/MOC activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.


Please ensure the computer system you plan to use meets the following minimum requirements:

  • Operating System: Windows 98 or higher & Macintosh 2.2 or higher
  • Internet Browser (Mac & Windows): Google Chrome, Safari 5.0.6 or higher, Firefox 3.0.3 or higher, & Opera 5 or higher
  • Broadband Internet connection: Cable, High-speed DSL & any other medium that is internet accessible
  • Media Viewing Requirements: Adobe Reader, Microsoft PowerPoint, Flash Player & HTML5


There is no fee for this activity. To receive credit, participants must take the pre-test, view this CME/MOC activity in its entirety, and then complete the post-test, with a score of 80% or better, and evaluation. The estimated time for completion of this activity is 1 hour. To receive their certificates, participants must demonstrate mastery of the presented material via the post-test. Participant is allowed to take the post-test multiple times.

Jointly provided by the Potomac Center for Medical Education and Rockpointe

In collaboration with the National Psoriasis Foundation

This activity is supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.

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