The upregulation of IL-36-gamma, IL-36-beta and of the IL-36 receptor antagonist in normal acral skin and the increase in IL-36-gamma in PPPP/PPP as compared to normal skin is interesting in view of the familial cases of pustular psoriasis reported in patients with mutations in the IL-36 receptor antagonist gene [17, 18]. Here, IL1RL2 is linked to pustular psoriasis.