Abstract: Long Fuquan, Liu Yeqiang, Qian Yihong, Meng Bingxin, Zhao Lishi, Wang Qianqiu Department of Venereology, Shanghai Dermatology Hospital, Shanghai 200043, China（Long FQ, Qian YH, Zhao LS）; Department of Pathology, Shanghai Dermatology Hospital, Shanghai 200043, China（Liu YQ）; Department of Dermatology, Hainan General Hospital, Haikou 570102, Hainan, China（Meng BX）; Department of Sexually Transmitted Disease Clinical Management, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China（Wang QQ） Corresponding author: Wang Qianqiu, Email: wangqq@ncstdlc.org 【Abstract】 Objective To investigate the association of tumor necrosis factor-α （TNF-α） gene promoter polymorphisms with generalized pustular psoriasis. Methods Totally, 91 patients of Han nationality with generalized pustular psoriasis （generalized pustular psoriasis group） and 102 health checkup examinees （healthy control group） were enrolled into this study. PCR and direct sequencing were performed to analyze the -238, -308 and -857 polymorphic sites of the TNF-α promoter. Results The frequency of the A allele at TNF-α-238 site was significantly higher in the generalized pustular psoriasis group than in the healthy control group （P = 0.003, OR = 4.819, 95% CI: 1.581 - 14.694）, so was the frequency of GA/AA genotype （P = 0.006, OR = 4.455, 95% CI: 1.410 - 14.077）. However, no significant differences were observed in the frequencies of G/A alleles （P = 0.794） and GG/GA/AA genotypes （P = 0.786） at TNF-α-308 site, or in the frequencies of C/T alleles （P = 0.474） and CC/CT/TT genotypes （P = 0.453）at TNF-α-857 site, between the generalized pustular psoriasis group and healthy control group. Conclusion TNF-α-238G > A polymorphisms may be associated with the occur-rence of generalized pustular psoriasis.