Psoriasis vulgaris (PV) is a cutaneous inflammatory disorder stemming from abnormal,
persistent activation of the interleukin- (IL-)23/Th17 axis. Pustular psoriasis (PP) is a
clinicopathological variant of psoriasis, histopathologically defined by the predominance
of intraepidermal collections of neutrophils. Although PP pathogenesis is thought to
largely follow that of (PV), recent evidences point to a more central role for IL-1, IL-36,
and IL-6 in the development of PP. We review the role of IL-6 in the pathogenesis of PV
and PP, focusing on its cross-talk with cytokines of the IL-23/Th17 axis. Clinical
inhibitors of IL-6 signaling, including tocilizumab, have shown significant effectiveness
in the treatment of several inflammatory rheumatic diseases, including rheumatoid
arthritis and juvenile idiopathic arthritis; accordingly, anti-IL-6 agents may potentially
represent future promising therapies for the treatment of PP.