Generalized pustular psoriasis (GPP) is a severe inflammatory cutaneous disease characterized by widespread pustules, edema, erythema, fever, and systemic inflammation. Chinese data indicate that the prevalence and incidence of GPP follow a bimodal age distribution, with peaks in the 0-3 year age group and the 30-39 year age group. 1 In the 0-3 year age group, the prevalence was 0.927 and the incidence rate was 0.742 per 100 000 population-years. 1 Interleukin (IL)-36 plays an important role in GPP by activating nuclear factor-κB (NF-κB) and mitogen-activated protein kinase (MAPK) signal pathways. 2 Chemokines (CXCL8, CXCL1, CXCL2, etc.), cytokines (IL-1β, tumor necrosis factor TNF-α, IL-6, IL-23, IL-17, etc.), and activated cells (e.g., keratinocyte, neutrophils, dendritic cells, etc.) are also involved. 3 Acitretin, cyclosporine, methotrexate, and etanercept were recommended as first-line treatments for children with GPP in 2012 by the American National Psoriasis Foundation. 4 However, recent findings suggest that biological agents targeting IL-36, TNF-α, IL-17, IL-23, or their receptors might be more promising options than conventional drugs. 5 Clinical trials and case series have also demonstrated the superiority of biological agents in adult and older pediatrics