Genetic analysis of different subtypes of Aseptic pustulosis in the Chinese population.

Aseptic pustulosis involves inflammatory skin conditions with non-bacterial pustules on red skin, accompanied by neutrophil and eosinophil infiltration in the epidermis. Dysregulation of the IL-36 pathway leads to neutrophil aggregation and pustule formation. Variants in IL36RN, CARD14, AP1S3, MPO, SERPINA3, and BTN3A3 genes have been identified in GPP in the past. Some patients with ACH, PPP, and AGEP also exhibit mutations in IL36RN, CARD14, and AP1S3 genes, albeit with regional and population-specific variations. This study aims to explore a shared genetic foundation among aseptic pustulosis. We performed Sanger sequencing on six genes in 126 aseptic pustulosis patients. Genetic analysis identified IL36RN variants strongly associated with ACH, AGEP, and SPD. Immunohistochemistry revealed elevated inflammatory cytokines in all subtypes. This study establishes a significant association between IL36RN variants and ACH, AGEP, and SPD, emphasizing the IL-1/IL-36 chemokine-neutrophil axis as a common pathogenic mechanism. Targeting this axis holds promise for therapeutic interventions in aseptic pustulosis.