Pustular psoriasis (PuP) is a rare variant of psoriasis, presenting with non-follicular pustules on top of inflamed skin. It is mainly classified into generalized PuP (GPP) and localized PuP, of which the latter includes palmoplantar pustulosis (PPP) and acrodermatitis continua of Hallopeau (ACH). 1 While PuP manifests in adulthood in most patients, in some patients, PuP manifests before 18 years of age and is known as juvenile-onset PuP (JPP).While most cohorts agreed in terms of female predominance in patients, the mean age of onset varied with each population and subtype, falling between the late twenties and late forties. In addition, diabetes mellitus and hypertension are also commonly found among PuP patients. 2