Although there have been numerous report of secukinumab successfully treating PRP, most of these cases have involved adults, with only one paediatric case, a 7year-old boy with Type V PRP. 4 Thus, to our knowledge, this first report that the IL-17A inhibitor secukinumab was effective in treating a child with severe Type III PRP. Although Type III PRP is often self-limiting, our patient's rash progressed rapidly with severe itching, even leading to the development of eyelid ectropion and erythroderma. The patient's symptoms improved significantly after the injection of secukinumab. The rapid remission of symptoms after injection may indicate that the patient's regression was not spontaneous, 2 which in turn suggests that secukinumab can be used as an alternative therapy for severe PRP in children. Despite a good effect of treatment with secukinumab in a few cases of psoriasis in children, 5 its safety and efficacy in children have not yet been established. Thus, further studies are required to evaluate the safety and efficacy of secukinumab in children with PRP. We will continue to monitor our patient to assess treatment safety and long-term prognosis.

Little is known about the volume of outpatient referrals for anogenital dermatoses received by NHS dermatology departments. We undertook a caseload analysis at our centre and found 6.0% of GP referrals to Dermatology were for anogenital dermatoses. This has important implications for training in this field of dermatology as well as for service provision.