Clinical characteristics and risk factors for a distinct pustular psoriasis flare after withdrawal of biologics in plaque psoriasis
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Supplementary Table 1. Laboratory evaluations and treatments during pustular flares. Supplementary Fig. 1. Representative clinical images of the distinct pustular psoriasis flare following biologic withdrawal. (A–B) Multiple tiny pustules arising on desquamated and crusted erythematous plaques on the bilaterally swollen lower limbs (representative case 2). (C) Multiple pustules with peripheral crusting and desquamation arising on annular erythematous plaques involving the bilaterally swollen lower limbs with diffuse erythema (representative case 3). (D) Numerous tiny pustules at the periphery of erythematous, yellowish-crusted, scaly plaques with erythema extending beyond the plaque margins on the lower limbs (representative case 4). (E–F) Pinhead-sized pustules arising from erythematous plaques with peripheral yellowish-to-white scales on the bilaterally swollen lower limbs (representative case 5). (G–H) Multiple pustules admixed with hyperkeratotic erythematous plaques on the bilaterally swollen lower limbs (representative case 6) Supplementary Fig. 2. Histopathologic examination showing features consistent with pustular psoriasis. (A) Histopathologic examination showed a subcorneal pustule (black arrow) (hematoxylin-eosin stain; original magnification, ×40). (B) Munro microabscesses (open black arrow), dilated capillaries in the dermal papillae (open arrowhead), a thinned suprapapillary plate (*), regular psoriasiform acanthosis (dashed arrow), and hypogranulosis (black arrow) (hematoxylin-eosin stain; original magnification, ×100).
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- National Taiwan University Hospital, Hsin-Chu branchGrant ID: 115-HCH001, HR-115-H04, 115-HCH101, and 115-HCH085
- National Science and Technology CouncilTaiwan, TaipeiGrant ID: MOST 109-2314-B-182A-012, MOST 110-2314-B-182A-104, MOST111-2314-B-182A-116, MOST 111-2314-B-002-244, NSTC 112-2314-B-002-073-MY3