A case of pustular psoriasis preceded by liver dysfunction

The patient is a female in her thirties. The patient was diagnosed with pustular psoriasis during the treatment course for pneumonia with the appearance of small pustules of the skin and with an increase of serum total bilirubin level. Pustular psoriasis is a designated intractable disease with extremely low prevalence in which the skin of the whole body is flushed with high fever and many sterile pustules occur. This disease has been reported to be accompanied by liver dysfunction. Liver dysfunction appeared 1-2 weeks after the eruption appears in most cases, but this is the rare case in which the liver disorder precedes.