Generalized pustular psoriasis is rare in children, especially in those less than 1 year of age. Lytic lesions of the bone have been reported in children with psoriasis, but are rare. We describe an infant with the clinical and histopathologic features of generalized pustular psoriasis that began in the first few weeks of life. In addition, this patient had sterile lytic lesions of the bone. Despite significant improvement in the bone lesions, his skin condition was resistant to therapy.