The onset of von Zumbusch pustular psoriasis can be abrupt. Within as little as a few hours after the skin becomes tender, the pustules appear. The pustules then dry and peel over the next 24 to 48 hours, leaving the skin with a glazed, smooth appearance. A fresh crop of pustules may then reappear.
Eruptions often come in repeated waves that last days or weeks.
The pus inside psoriasis pustules consists of white blood cells. It is not an infection and it is not contagious. A person can have a history of plaque psoriasis for years and then develop recurrent episodes of von Zumbusch. This form can cause fever, chills, severe itching, a rapid pulse rate, exhaustion, anemia, weight loss and muscle weakness. The objective of treatment is to restore the skin's barrier function, prevent further loss of fluid, stabilize the body's temperature and restore the skin's chemical balance.