A Successful Treatment of Ostraceous Psoriasis Associated with Psoriatic Arthritis in Children: A Case Report

Rowawi, Rasmia; Dwipangestu, Gilang; Suwarsa, Oki; Dharmadji, Hartati Purbo; Sutedja, Endang; Pangastuti, Miranti; Gunawan, Hendra

doi:10.2147/ptt.s285832

PTT

2020

DOI: 10.2147/ptt.s285832

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A Successful Treatment of Ostraceous Psoriasis Associated with Psoriatic Arthritis in Children: A Case Report

Rasmia Rowawi

Gilang Dwipangestu

Oki Suwarsa

et al.

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Cited by 3 publications

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“…Some authors do not di erentiate between hyperkeratotic forms of psoriasis [1]. Due to the dense scales observed in these cases, systemic treatment in the form of oral cyclosporine or methotrexate injections was primarily used to manage the reported cases [1][2][3][4][5]. With in iximab, a case of ostraceous psoriasis with psoriatic arthritis has been resolved [6].…”

mentioning

confidence: 99%

Complete response with guselkumab in a patient with double presentation of recalcitrant hyperkeratotic psoriasis over 18 months: a case report

Saleh

2024

Ann. Med. Surg. Dermatol.

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Background: Psoriasis is a chronic in ammatory skin disease with many clinical presentations. The most common variety is chronic plaque psoriasis. Rare chronic plaque psoriasis subtypes include annular, licheni ed, and hyperkeratotic. Hyperkeratotic forms include ostraceous, rupioid, and elephantine. Some authors ignore the distinction between the types of hyperkeratotic psoriasis. Nevertheless, biological therapies have not been extensively researched in such rare cases of psoriasis. We present a case of intractable hyperkeratotic psoriasis that was successfully treated with guselkumab. Case presentation: According to the physical examination of our 45-year-old male patient, the abdomen had con uent plaques and thick sero-exudative crusts. Erythematous, crusted, limpet-like lesions covered the back. The scales passed the Grattage test. The biopsy showed psoriasis features. After two months of guselkumab therapy, lesions were PASI 100. After a year of 8-week guselkumab medication, the patient's reaction was unchanged. Accordingly, guselkumab was given every 10 weeks for six months. The patient was disease-free except for a few minor lesions on the back and abdomen that disappeared following topical steroid cream. Conclusions: Our patient had elephantine and rupioid psoriasis on the abdomen and back, respectively. This twofold presentation in the same patient supports the idea that hyperkeratotic psoriasis subtypes are interchangeable. The natural evolution of hyperkeratotic psoriasis lesions may explain this appearance, which has never been recorded. In this case report, guselkumab was highly e ective at treating severe hyperkeratotic psoriasis in a real-world clinical environment for 1.5 years.

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confidence: 99%

Complete response with guselkumab in a patient with double presentation of recalcitrant hyperkeratotic psoriasis over 18 months: a case report

Saleh

2024

Ann. Med. Surg. Dermatol.

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Rupioid psoriasis, a unique presentation treated with Ustekinumab

Diab,

Al-janabi,

Diab

et al. 2024

Oxford Medical Case Reports

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Rupioid psoriasis is a rare subtype of psoriasis characterized by distinctive lesions resembling oyster shells, known as rupioid lesions. This subtype is particularly uncommon in the pediatric population and is often associated with poor treatment compliance. Ustekinumab, an IgG monoclonal antibody, targets IL-12 and IL-23, reducing the release of proinflammatory cytokines TNFα, IL-2, and IL-17α, which play vital roles in psoriasis pathophysiology. Approved for pediatric patients aged six years and older, ustekinumab provides a therapeutic option for moderate to severe psoriasis. We present the case of a 10-year-old girl diagnosed with psoriasis vulgaris at age two. She presented with rupioid lesions following a urinary tract infection that had been treated with oral cefixime (200 mg). After conducting appropriate tests, ustekinumab (45 mg subcutaneously) was administered, leading to significant improvements in the thickness of the lesions and overall appearance. This case demonstrates ustekinumab’s efficacy in treating this challenging form of psoriasis.

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Deciphering the Function of New Therapeutic Targets and Prospective Biomarkers in the Management of Psoriasis

Purewal,

Doshi

2023

CDT

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Psoriasis is an immune-mediated skin condition affecting people worldwide, presenting at any age, and leading to a substantial burden physically and mentally. The innate and adaptive immune systems interact intricately with the pathomechanisms that underlie disease. T cells can interact with keratinocytes, macrophages, and dendritic cells through the cytokines they secrete. According to recent research, psoriasis flare-ups can cause systemic inflammation and various other co-morbidities, including depression, psoriatic arthritis, and cardio-metabolic syndrome. Additionally, several auto-inflammatory and auto-immune illnesses may be linked to psoriasis. Although psoriasis has no proven treatment, care must strive by treating patients as soon as the disease surfaces, finding and preventing concurrent multimorbidity, recognising and reducing bodily and psychological distress, requiring behavioural modifications, and treating each patient individually. Biomarkers are traits that are assessed at any time along the clinical continuum, from the early stages of a disease through the beginning of treatment (the foundation of precision medicine) to the late stages of treatment (outcomes and endpoints). Systemic therapies that are frequently used to treat psoriasis provide a variety of outcomes. Targeted therapy selection, better patient outcomes, and more cost-effective healthcare would be made possible by biomarkers that reliably predict effectiveness and safety. This review is an attempt to understand the role of Antimicrobial peptides (AMP), Interleukin-38 (IL-38), autophagy 5 (ATG5) protein and squamous cell carcinoma antigen (SCCA) as biomarkers of psoriasis.

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A Successful Treatment of Ostraceous Psoriasis Associated with Psoriatic Arthritis in Children: A Case Report

Cited by 3 publications

References 10 publications

Complete response with guselkumab in a patient with double presentation of recalcitrant hyperkeratotic psoriasis over 18 months: a case report

Complete response with guselkumab in a patient with double presentation of recalcitrant hyperkeratotic psoriasis over 18 months: a case report

Rupioid psoriasis, a unique presentation treated with Ustekinumab

Deciphering the Function of New Therapeutic Targets and Prospective Biomarkers in the Management of Psoriasis

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