Generalized pustular psoriasis in Brazil: A public claims database study

Background: Generalized pustular psoriasis (GPP) is a rare and severe phenotype of psoriasis characterized by sudden outbreak of widespread coalescent sterile pustules associated with a spectrum of systemic symptoms. Objective: We aimed to describe the epidemiology and treatment of GPP in Brazil from the public health care system perspective. Methods: This was a retrospective public claims database study, using outpatient and inpatient databases, with information from January 2018 to August 2020, based on records of health resource utilization by patients with GPP. Outpatient treatment regimens and fatal inpatient outcomes were described. Results: In total, 1458 outpatients of all ages were identified, of whom 53% were women. We estimated the GPP prevalence in Brazil to be between 0.7 and 0.9 per 100,000. Acitretin was the most commonly dispensed drug. Of all the outpatients, 769 outpatients could be tracked in the inpatient database, and 151 had hospital admissions during the study period. Of them, 5.3% had a fatal outcome during hospitalization. A primary skin condition or an infection was the most frequent hospitalization cause. Limitation: The International Classification of Diseases codes for GPP and psoriasis have not been previously validated in this context. Conclusion: GPP is a rare disease in Brazil and affects individuals of all ages and both sexes. Hospitalizations and disease -related deaths highlight the need for its prompt diagnosis, close medical follow-up, and effective treatment. ( JAAD Int 2022;6:61-7.)