A patient with psoriasis was started on systemic steroids. After stopping the treatment, the patient developed generalized pustules all over the body. The cause is most likely to be:

Ans. D. Pustular psoriasis* Generalized pustular psoriasis(GPP) is an uncommon variant of psoriasis in which an acute, subacute or occasionally chronic eruption has sterile pustulosis as its central feature.* Coal tar and dithranol may provoke postulation if injudiciously continued when the psoriasis is intolerant. Other provocating. Factors include infection, pregnancy and hypocalcaemia associated with hypoparathyroidism.* Drug implicated have included salicylates, iodide, lithium, phenylbutazone and oxyphenbutazone and progesterone, terbinafine and amfebutamone.* The most important drug provocation is by withdrawal of systemic corticosteroids.* Intensive topical therapy with strong corticosteroids under occlusion has also been implicated