CARD14‐associated papulosquamous eruption (CAPE) in a toddler responding to treatment with acitretin

Abstract

CARD14-associated papulosquamous eruption (CAPE) is a rare autosomal dominant dermatosis that presents classically in early childhood with clinical features of both psoriasis and pityriasis rubra pilaris (PRP). The disease is known to be refractory to topical and systemic therapies classically used for psoriasis, with the majority of reported cases requiring treatment with biologics, such as ustekinumab and secukinumab. We present a toddler with a clinical presentation consistent with CAPE and found to have a novel heterozygous variant of the CARD14 gene. She was refractory to treatment with topical emollients and topical corticosteroids, but responsive to oral acitretin.

HomozygousCARD14variant presenting as infantile erythroderma

“…CAPE presents a therapeutic challenge as it is often refractory to conventional treatment, with unsatisfactory responses recorded even with tumour necrosis factor-α inhibitors 1 14. An exception to this is a case of a 17-month-old girl diagnosed with CAPE who improved with acitretin at a maximum dose of 0.35 mg/kg 15. Though there was a mild decrease in erythema and scaling in our patient, the erythroderma persisted even while he was on acitretin.…”