Clinical phenotypes of 504 patients with pustular psoriasis from Europe and Egypt: a multicentre observational study
Bibliographic record
Abstract
BACKGROUND: Pustular psoriasis (PP) comprises a group of rare autoinflammatory skin diseases characterized by sterile pustules. Previous studies have focused on cohorts in East Asia and the West, while North African populations have been underrepresented. OBJECTIVES: To describe the demographic and clinical features of a large cohort of European and Egyptian patients with PP. METHODS: We collected data on 504 patients with PP from 13 centres across Egypt and 5 European countries (Estonia, Germany, Spain, Switzerland and the UK); we then analysed their demographic profiles, clinical presentations and treatment histories. RESULTS: Of 504 patients with PP (424 Europeans and 80 Egyptians), 78 (15.5%) had generalized pustular psoriasis (GPP), 374 (74.2%) had palmoplantar pustulosis (PPP), 12 (2.4%) had acrodermatitis continua of Hallopeau (ACH) and 40 (7.9%) had other or overlapping PP subtypes. PPP was more prevalent among Europeans than among Egyptians (83% vs. 28%), whereas GPP was more prevalent among Egyptians than among Europeans (60% vs. 7%). Europeans included more women than men (80% vs. 40% with GPP, and 79% vs. 23% with PPP; both P < 0.001). The mean age (SD) of European patients was significantly higher than that of Egyptian patients [59.9 (16.8) vs. 36.1 (18.6) years with GPP and 62.2 (16.4) vs. 40.2 (13.8) years with PPP; both P < 0.001]. European patients with GPP had higher rates of psoriasis vulgaris (PV) than Egyptian patients with GPP (29% vs. 10%; P = 0.043). Treatment patterns varied, with ciclosporin being frequently used in Europe, while treatment with methotrexate and steroids was more common in Egypt. CONCLUSIONS: This study highlights significant variations between European and Egyptian patients with PP. European patients more commonly presented with PPP, whereas Egyptian patients had a higher incidence of GPP and fewer diagnoses of comorbid PV.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".