Generalized pustular psoriasis is rare in children and has an explosive onset with sheets of pustules on a background of bright erythema accompanied by severe systemic toxicity. It may be the first presentation of psoriasis and settle spontaneously in a few weeks leaving normal skin. It often recurs and usually more typical psoriasis eventually supervenes. Pustular psoriasis of the palms and soles is also very rare in children. Acropustulosis, a glazed erythema studded with pustules followed by thick scaling and fissuring, involving one or more digits, is an occasional childhood presentation.