Successful secukinumab treatment of erythrodermic psoriasis and psoriatic arthritis concomitant with severe noninfectious uveitis: a case report

Lu, Jiajing; Tang, Suwei; Yu, Na; Xie, Yonggang; Liu, Ying

doi:10.1177/0300060520969494

Cited by 9 publications

(5 citation statements)

References 17 publications

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“…21 This article reviews the literature on the successful treatment of EP with secukinumab (Table 1). Patients who did not respond well to other biological agents or traditional treatments or patients with other serious diseases such as end-stage renal disease, noninfectious uveitis, and HIV are included in Table 1, 3,22,23 indicating that secukinumab may be a viable option for patients with EP who do not respond to other treatments and have severe comorbidities. 24 However, the National Psoriasis Foundation's guideline for the use of biologics in EP, published in 2019, recommends that secukinumab be characterized only as a "grade C" recommendation for treating EP.…”

Section: Discussionmentioning

confidence: 99%

“…Erythrodermic psoriasis (EP) is an uncommon and severe form of psoriasis characterized by generalized scaly erythema involving more than 75% of the body surface area, with numerous complications and a high mortality rate 1 . Currently, the safety and efficacy of secukinumab for the treatment of EP have been confirmed, with several reports of successful treatment in adult EP, 2,3 while there is only one reported successful EP treatment using secukinumab in children 4 . Herein, we present a case of vaccine‐induced EP in a 7‐year‐old boy successfully treated with secukinumab combined with symptomatic therapy and supportive care, as well as a brief literature review of the disease.…”

Section: Introductionmentioning

confidence: 89%

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Vaccine‐induced erythrodermic psoriasis in a child successfully treated with secukinumab: A case report and brief literature review

Zhao

Zhang

Wang

et al. 2022

Dermatologic Therapy

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We report a case of a 7-year-old male patient with vaccine-induced erythrodermic psoriasis (EP) complicated by pulmonary infection, hypoproteinemia, and liver dysfunction successfully treated with secukinumab in combination with symptomatic and supportive therapy. The patient presented with diffuse flushing on the head, face, trunk, and limbs, which were covered with chaff-like white scales in the rashaffected area, with no blisters, pustules, and no apparent abnormalities in the palms, soles, nails, and joints. Histopathology analysis revealed hyperkeratosis, focal parakeratosis, thinning or effacement of the granular layer, psoriasiform hyperplasia of the epidermis, neutrophilic microabscess formation in the upper part of the epidermis, edema of the dermal papilla, dilation of blood vessels, and lymphocyte infiltration. The patient was eventually diagnosed with EP. At weeks 0, 1, and 2, the patient received a subcutaneous injection of 150 mg secukinumab (three injections). Fluticasone propionate ointment, taccathitol ointment, yellow vaseline, and other drugs were also given topically. Following 2 weeks of treatment, the child's skin lesions resolved significantly with only slight pigmentation remaining and the Psoriasis Area and Severity Index (PASI) score decreased from 37.5 to 7.5 (PASI 75). Thereafter, 150 mg secukinumab was injected every 4 weeks until the last dose at 18 weeks (four more injections). After 18 weeks, the child's lesion resolved entirely (PASI 100), and no adverse effects were reported.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

Vaccine‐induced erythrodermic psoriasis in a child successfully treated with secukinumab: A case report and brief literature review

Zhao

Zhang

Wang

et al. 2022

Dermatologic Therapy

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“…83 Its use in the management of EP has been reported in several case series [27][28][29][30][31][32] and case reports. [33][34][35][36][37][38]84 However, there are no clinical trials available. The largest case series has been reported by Damiani et al who reported the results of a multi-center, international, retrospective, pilot study enrolling 13 EP patients receiving secukinumab for 52 weeks.…”

Section: Secukinumabmentioning

confidence: 99%

Biologics for the Management of Erythrodermic Psoriasis: An Updated Review

Potestio¹,

Camela²,

Cacciapuoti³

et al. 2023

CCID

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Erythrodermic psoriasis (EP) is a severe and rare variant of psoriasis (less than 3% of cases), characterized by generalized scaling and erythema affecting more than 90% of body surface area. Several systemic symptoms can be present in patients with EP such as lymphadenopathy, arthralgia, fever, fatigue, dehydration, serum electrolyte disturbances, and tachycardia making this condition a possible life-threatening disease, particularly if appropriate treatments are not performed. In this scenario, effective and safe therapies are required. Unfortunately, the rarity of EP makes head-to-head Phase III trials challenging, leading to the lack of established guidelines for its management. Globally, conventional systemic drugs such as cyclosporine, methotrexate, and retinoids often have contraindications linked to patients' comorbidities and have not shown a high profile of efficacy and safety. Recently, the development of biologic drugs including anti-tumor necrosis factor-α and anti-interleukin 12-23, 23, and 17 has revealed favorable results for the management of plaque psoriasis, making them also a possible therapeutic option for EP disease. However, their use in EP is still offlabel. The aim of our study was to review current literature on the use of biologic drugs for the treatment of EPs in order to offer a wide perspective on their possible application in EP management.

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“…T17 cells play a key role in sustaining the inflammatory cascade in psoriasis. Secukinumab was the first IL-17A inhibitor to emerge as one of the preferred biological agents to manage chronic psoriasis in patients with multiple comorbidities, including uveitis (36). Notably, ustekinumab has also demonstrated good results in uveitis (37).…”

Section: Ophthalmological Changesmentioning

confidence: 99%

Psoriasis beyond the skin: Ophthalmological changes (Review)

et al. 2021

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Psoriasis is a chronic, immune-mediated inflammatory disease of unknown etiology that may be associated with abnormal T-lymphocyte function. Ocular manifestations associated with psoriasis, particularly artropathic or pustular psoriasis, usually affect men, often during exacerbations of the disease. It has been reported that eye damage tends to occur later compared with cutaneous or joint manifestations, blindness being the most disabling complication. Previous studies have focused on ophthalmic manifestations and identified several etiopathogenic mechanisms. Psoriasis may be associated with eye complications such as lesions of the eyelids, conjunctiva and others, with systemic inflammation being the main contributor. In addition, the treatment used for psoriasis may cause ocular changes. The main ophthalmic manifestations associated with psoriasis are keratoconjunctivitis sicca, blepharitis, conjunctivitis and uveitis. The treatment of uveitis, perceived as one of the most serious eye conditions, is controversial and has yet to be clearly determined. Thus, the aim of the present review was to emphasize the importance of regular eye examination for patients with psoriasis, either those receiving biological treatment or those not receiving treatment, in order to diagnose and manage the disease appropriately.

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Successful secukinumab treatment of erythrodermic psoriasis and psoriatic arthritis concomitant with severe noninfectious uveitis: a case report

Cited by 9 publications

References 17 publications

Vaccine‐induced erythrodermic psoriasis in a child successfully treated with secukinumab: A case report and brief literature review

Vaccine‐induced erythrodermic psoriasis in a child successfully treated with secukinumab: A case report and brief literature review

Biologics for the Management of Erythrodermic Psoriasis: An Updated Review

Psoriasis beyond the skin: Ophthalmological changes (Review)

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