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CME: Present and novel approaches in the medical management of generalized pustular psoriasis: balancing out the therapeutic landscape

Activity Description / Statement of Need:

In this online, self-learning activity:

Psoriasis is a T-lymphocyte-mediated condition that is one of the most common immune-mediated inflammatory diseases in the North America and Europe. Plaque psoriasis is the most common form of psoriasis, but several, rarer subtypes of psoriasis have been described, including pustular psoriasis, wherein neutrophils infiltrate the epidermis and present as raised, sterile pustules. One form of pustular psoriasis is generalized pustular psoriasis (GPP), which is characterized by primary, macroscopically visible pustules on the non-acral skin that may occur with or without systemic inflammation and may be relapsing or persistent. Another form is palmoplantar pustulosis (PPP), a persistent condition that is persistent and localized to the palms, soles, or both. These subtypes may be severe and life-threatening and pose a significant healthcare burden, contributing to hospital admissions, higher healthcare resource utilization, and reducing patient quality of life. One survey shows that a majority of patients live under psychological duress and experience at least two flares annually. The same sample reports that condition has a significant impact on their activities of daily living.

Target Audience:

HCPs including: Dermatologists, primary care physicians, and emergency medicine physicians; physician assistants, nurse practitioners, nurses, and pharmacists who practice in the aforementioned areas of specialty; and those with an interest in or commonly encounter patients with pustular psoriasis.  

Commercial Support Disclosure: This program is supported by an educational grant from Boehringer Ingelheim Pharmaceuticals.

This activity is free of charge.

Release Date: September 01, 2023 -- Expiration Date: September 01, 2025

Faculty: Scott Worswick, MD


Faculty introduction, disclosures

Differential Diagnosis of GPP

o    Common causes of AGEP 

o    How to distinguish GPP from other diagnostic entities in clinical presentation 

- DRESS, AGEP, disseminated candida, mycoplasma, sub-corneal pustular dermatosis, Ofuji's syndrome

o    Labs and other features that can be useful to distinguish differential diagnoses of patients with pustules

GPP diagnostic and therapeutic considerations

  • Clinical clues, including nail changes, to look for in GPP patients
  • Therapeutic options for the treatment of GPP

o    Appropriate therapies & their dosages

- Focus on two randomized controlled trials including spesolimab

o    Adverse effects

o    Specialized patient considerations: pregnant patients, IL36RN mutation status, underlying organ dysfunction

Summary of clinical and therapeutic pearls, conclusions

Learning Objectives

By the end of the session the participant will be able to:

  • Describe ways in which GPP may be distinguished from other dermatologic conditions in the differential diagnosis, and apply that information to a patient case.
  • Use labs and other diagnostic tools to refine the differential of a patient with a widespread pustular eruption.
  • Discuss the ways in which physical examination of the skin and nails improves diagnostic ability in a patient presenting with widespread pustules.
  • Recall conventional and newer therapies for GPP and their mechanisms of action, dosing, and side effects, and apply that information to a patient case.


ACCME Activity #202547079

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.


ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-23-030-H01-P. This is an Knowledge (K)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurses: The American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts AMA PRA Category 1 Credit™ assigned by organizations accredited by the ACCME as satisfying Category 1 CME for National Commission on Certification of Physician Assistants (NCCPA) national certification maintenance. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Board (AANPCB) states that continuing education providers accredited by the ACCME may provide acceptable, accredited Advanced Practice Provider content. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosures of Faculty: Scott Worswick, MD, Associate Clinical Professor, Department of Dermatology, Keck School of Medicine of USC, has received financial compensation from Boehringer Ingelheim for consulting and speaker's bureau work.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty WILL discuss off-label uses of a commercial product.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Boehringer Ingelheim Pharmaceuticals.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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