Successful treatment of juvenile generalized pustular psoriasis with infliximab therapy: two case reports

Background: Infliximab, a tumor necrosis factor α antagonist, has recently been shown to be successful for the short-term treatment of generalized pustular psoriasis (GPP) in multiple case reports. Objective: The goal of this case series was to assess the efficacy of the longer-term management of GPP with infliximab. Methods: Three patients with severe GPP were followed to assess the efficacy of long-term treatment with infliximab. Results: Infliximab therapy was more efficacious with infusion every 6 to 8 weeks in combination with methotrexate. Conclusion: Infliximab may be efficacious for some patients for the long-term management of GPP. Maintaining a strict infliximab infusion schedule and concomitant methotrexate therapy may decrease infusion reactions and increase efficacy.

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Successful Treatment of Generalized Pustular Psoriasis of Pregnancy with Oral Cyclosporine

SKIN The Journal of Cutaneous Medicine ◽

10.25251/skin.4.3.6 ◽

2020 ◽

Vol 4 (3) ◽

pp. 252

Author(s):

Hamid Khederlou ◽

Zahra Najmi ◽

Narges Mohammadi ◽

Shahla Atrak ◽

Nader Ghaffari

Keyword(s):

Successful Treatment ◽

Male Infant ◽

Pustular Psoriasis ◽

Third Trimester ◽

The Third ◽

Generalized Pustular Psoriasis ◽

Laboratory Investigations

Generalized pustular psoriasis of pregnancy (GPPP) is a rare dermatosis that usually occurs during the third trimester of pregnancy. The diagnosis is primarily clinical, confirmed by laboratory investigations and histopathological typical findings. Here we report, a 26-year-old, gravida one woman, in 37 weeks of pregnancy, presenting with extensive erythematous, pruritic plaques with peripheral scaling and pustules. Patient was induced at 37+4 weeks and delivered a healthy 2900g male infant. GPPP was eventually controlled with oral cyclosporine.

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Two case reports of generalized pustular psoriasis of pregnancy: Different outcomes

Obstetric Medicine ◽

10.1177/1753495x15626623 ◽

2016 ◽

Vol 9 (2) ◽

pp. 55-59 ◽

Cited By ~ 2

Author(s):

Aoibheann Flynn ◽

Naomi Burke ◽

Bridgette Byrne ◽

Noreen Gleeson ◽

Bairbre Wynne ◽

...

Keyword(s):

Case Reports ◽

Pustular Psoriasis ◽

Skin Disorders ◽

Generalized Pustular Psoriasis ◽

Maternal Sepsis ◽

In Pregnancy

Generalized pustular psoriasis of pregnancy is a rare dermatosis with potential serious consequences for both the mother and fetus. Treatment is difficult and historically steroids were the mainstay of treatment. Cyclosporin has been used for a few cases resistant to steroids. We report our own experience of two cases of generalized pustular psoriasis of pregnancy. Cases of generalized pustular psoriasis of pregnancy need review by a dermatologist with experience of skin disorders in pregnancy. Both the fetus and mother need to be monitored closely when systemic illness occurs, as there is a risk of stillbirth. Maternal sepsis is a known complication of generalized pustular psoriasis of pregnancy. Cyclosporin, when used appropriately is effective and relatively safe.

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