Increased risk of severe generalized pustular psoriasis due to tuberculosis screening delay for spesolimab initiation

To the Editor: Generalized pustular psoriasis (GPP) is a rare, potentially life-threatening pustular dermatosis. Over half of patients with GPP require hospitalization, and the mortality rate due to complications is 33 per 1,000 person-years.1 The in-hospital mortality rate of patients with GPP, however, is lower for those who receive treatment with biologics (1%) versus treatment with corticosteroids (9.1%) or oral agents alone (3.7%).2