Pustular psoriasis and erythrodermic psoriasis are generally less stable, more challenging to treat, and more severe for the patient than classical plaque-type psoriasis vulgaris. The risk for systemic infection and overwhelming sepsis in these forms of psoriasis emphasizes the potential life-threatening impact of psoriasis. Careful attention to management strategies enables the astute clinician to help the patient improve, despite the challenges these difficult forms of psoriasis present.