Pustular

Pustular is an adjective used in medicine, especially dermatology, to describe lesions or eruptions that contain or resemble pus. A pustule is a small, raised, pus-filled lesion resulting from neutrophilic inflammation in the skin. Pustular conditions can be localized or widespread and may arise from infection, inflammatory diseases, or medication reactions.

In dermatology, several well-described pustular conditions are recognized. Palmoplantar pustulosis involves recurrent sterile pustules on the palms and soles, often with scaling and crusting. Generalized pustular psoriasis (GPP) is a potentially serious form of psoriasis marked by widespread sterile pustules, fever, and systemic symptoms. Acute generalized exanthematous pustulosis (AGEP) is a rapid-onset rash with numerous pustules, usually triggered by a medication reaction, and can be accompanied by fever and leukocytosis. Pustular dermatitis can also appear as localized eruptions in various inflammatory or infectious contexts, and is sometimes contrasted with vesicular or nonpustular rashes.

Diagnosis typically rests on clinical examination, with additional laboratory tests to assess systemic involvement or to distinguish noninfectious pustulation from infection. Skin biopsy may be used in uncertain cases to support a specific diagnosis. Cultures or PCR may be employed to identify infectious causes when indicated.

Management depends on the underlying cause and the extent of the eruption. Localized pustules may respond to topical corticosteroids and antiseptics, while widespread pustulation often requires systemic therapy and management of associated symptoms. In drug-induced cases such as AGEP, removing the offending medication is essential. Prognosis varies by condition and severity; some pustular disorders resolve with treatment, while others may be chronic or recurrent.