Abstract: Objective: To investigate the clinical features and treatments of childhood pustular psoriasis (PP) and subtypes. Methods: A retrospective study was undertaken for 61 inpatient childhood PP in our hospital from Dec.2013 to Jul. 2018. Results: Totally 61 patients with  childhood PP  were analysed including35 cases of generalized pustular psoriasis (GPP; von Zumbusch), 4 cases of annular pustular psoriasis (APP), 15 cases of psoriasis vulgaris with pustules (PVP) and 7 cases of pustular erythrodermic psoriasis (PEP). Upper respiratory tract infections and drug withdrawal were the most common predisposing factors. The median age of onset was smallest (8.0 years old) in von Zumbusch and largest (12 years old) in APP. The proportion of boys was higher than girls in all variants except PVP (0.67∶1), and the proportion of patients with previous PV (73.3%) and family history (40.0%) was higher in PVP than others. In contrast, there was the smallest rate for patients with family history (11.4%) in von Zumbusch. The main treatments for von Zumbusch and APP were first-line monotherapy combined with basic treatments, and acitretin was the main choice. Basic treatments were the main treatments for PVP. PEP was a serious subtype which needed acitretin to combine with methotrexate and basic treatments. Conclusion: The clinical characteristics and treatments are different between subtypes of childhood PP, and correct typing contributes to choosing reasonable treatments.

Key words: childhood pustular psoriasis, subtypes, clinical features, treatments