Long-Term GPP Management Requires Coordinated Care Beyond the Acute Flare
Generalized pustular psoriasis (GPP) management should extend beyond acute flare control to include comorbidity assessment, structured care transitions, maintenance therapy, and multidisciplinary coordination, according to Henry Yu, PA-C, at the Masterclasses in Dermatology NP/PA Institute.
During his session “Beyond the Flare: Managing GPP Care from Acute to Chronic Treatment,” Yu emphasized that GPP rarely occurs without substantial comorbidity. Metabolic, cardiovascular, renal, and psychiatric conditions can influence treatment selection, safety monitoring, and patients’ ability to adhere to therapy.
“Comorbidities are the rule, not the exception,” Yu emphasized. Comprehensive comorbidity assessment and recognition of clinical red flags should therefore be incorporated into both inpatient and outpatient management.
The transition from acute treatment to outpatient maintenance represents a particularly vulnerable period. Inadequate dose tapering, premature treatment discontinuation, and other transition challenges may contribute to early flare recurrence. Yu recommended structured discharge checklists, confirmation of maintenance therapy access before discharge, early follow-up, and clear patient-facing action plans.
Long-term management should integrate pharmacologic maintenance, trigger mitigation, and patient engagement into an individualized care plan that evolves over time. Adherence is another critical consideration. Nonadherence to maintenance therapy was identified as a leading modifiable contributor to preventable flares, hospitalizations, and disease progression.
Yu also emphasized that complex or recurrent GPP requires coordination across specialties. “Multidisciplinary care is not optional,” he stated. Rheumatology, nephrology, psychiatry, social work, and primary care can serve as partners alongside dermatology, supported by proactive referral pathways and structured communication.
Social determinants, including transportation, cost, insurance barriers, and emotional burden, should also be incorporated into treatment planning. Social work, telehealth, and patient support programs may help address these barriers.
Reference
Yu H. Beyond the flare: managing GPP care from acute to chronic treatment. Presented at: Masterclasses in Dermatology NP/PA Institute; October 17–18, 2026; Dallas, TX.
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Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of the Dermatology Learning Network or HMP Global, their employees, and affiliates.
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