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April 2016

Acute Generalized Pustular Psoriasis Treated With the IL-17A Antibody Secukinumab

Author Affiliations
  • 1Department of Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
JAMA Dermatol. 2016;152(4):482-484. doi:10.1001/jamadermatol.2015.4686

We describe a patient with acute generalized pustular psoriasis (GPP) treated with the new anti–interleukin (IL)-17A antibody, secukinumab, who showed a remarkable response with almost complete resolution of pustulation after the first injection. To our knowledge, there are no data in the literature evaluating the efficacy of secukinumab in GPP.

A man in his 50s with a 7-year history of GPP was admitted with an acute, severe flare of pustulation. On exanimation, he was febrile, drowsy, and had disseminated, partly confluent lakes of painful pustules primarily over the trunk as well as the upper and lower extremities, with widespread erosions on the lower legs. There was generalized erythema involving 80% of his body surface area (BSA), and his GPP area and severity index was 47.6 (Figure 1A). The GP area and severity index is calculated in the same way as the psoriasis area and severity index except that the scale score is substituted with a pustule score.1 The dermatology life quality index (DLQI) on admission was 25.

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