1. Dysregulation of multiple immunological pathways: -the IL-17 pathway, leading to excessive inflammation and skin lesions;-IL-36 pathways that lead to increased production of inflammatory mediators, contributing to the development and exacerbation of skin lesions; -overexpression of IL-8 can lead to an accumulation of neutrophils, which are a hallmark of pustular lesions [28].2. The role of the microbiome [28,29]. This evidence concerns the gene IL17A and Pustule.