By Gary M. White, MD

Annular Pustular Psoriasis These photos of APP were taken late, during the desquamative phase.

Annular pustular psoriasis (APP) is a rare form of pustular psoriasis, characterized by erythematous, annular, or polycyclic lesions, eruptions of small sterile pustules, and fine desquamation.


The patient presents with recurrent, erythematous, annular or polycyclic lesions, and an eruption of small sterile pustules and fine desquamation. The patches extend from the center and resolve within some weeks, leaving scales and changes in pigmentation and pigmentary change.


The usual approaches to psoriasis including topical steroids may be tried. Oral acitretin may be beneficial.


Ann Dermatol. 2014 Apr; 26(2): 260–261.

Ann Dermatol. 2012 May; 24(2): 233–234

Additional Pictures

A tiny pustule is seen in the forth photo, lower right.
Annular Pustular Psoriasis Annular Pustular Psoriasis Annular Pustular Psoriasis Annular Pustular Psoriasis


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