Generalized pustular psoriasis is a relatively rare variant of psoriasis characterized by diffuse eruption of sterile pustules on an erythematous background. Untreated flares can result in life-threatening complications including sepsis and organ failure. Generalized pustular psoriasis has historically proven challenging to treat with an unpredictable clinical course and paucity of reliably efficacious treatment options. Until recently, there have been no FDA-approved therapies for generalized pustular psoriasis in the United States. In September 2022, the IL-36 receptor antagonist spesolimab became the first FDA-approved treatment for generalized pustular psoriasis in adults. We present a case of generalized pustular psoriasis with complete and rapid response to spesolimab.

Hidradenitis suppurativa (HS), a chronic inflammatory disease characterized by painful abscesses and nodules, has limited effective treatment options. However, adjuncts to standard therapeutics such as dietary modifications have been increasingly investigated in recent years. This comprehensive review aimed to analyze the literature concerning the relationship between HS and 28 essential vitamins and minerals. A literature search was performed via PubMed, Embase, Ovid, and Scopus using search terms related to HS and the essential vitamins and minerals. A total of 215 unique articles were identified and analyzed. Twelve essential nutrients had documented associations with HS; definitive supplementation or monitoring recommendations were identified for 7 of the 12 HS-associated nutrients in the literature. Evidence is growing that supports adjunct supplementation of zinc, vitamin A, and vitamin D in the treatment of HS. Further, obtaining serum levels of zinc, vitamin A, vitamin D, and vitamin B12 upon initial diagnosis of HS may be beneficial to optimize standard HS treatment. In conclusion, optimizing nutrition in addition to standard HS therapeutics may help reduce disease burden; however more research is needed.