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Favorable response to apremilast in a patient with refractory psoriasis verrucosa
Author(s) -
Okazaki Sari,
Osawa Risa,
Nakajima Hideki,
Nakajima Kimiko,
Sano Shigetoshi
Publication year - 2019
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.14877
Subject(s) - medicine , etretinate , apremilast , generalized pustular psoriasis , psoriasis , dermatology , refractory (planetary science) , methotrexate , lesion , plaque psoriasis , clearance , trunk , surgery , psoriatic arthritis , ecology , physics , astrobiology , biology , urology
A 67‐year‐old man, who had been diagnosed with psoriasis 30 years prior, visited our hospital with a complaint of verrucous nodules in the lower legs, which had developed 15 years previously. We diagnosed him as having psoriasis verrucosa of the legs and plaque psoriasis of the torso. Because the lesions were resistant to topical glucocorticoids and vitamin D 3 , a verrucous lesion in the right leg was treated with surgical ablation, which resulted in the development of generalized pustular psoriasis. After pustular lesions were cleared by systemic glucocorticoids and methotrexate, we treated him with etretinate and cyclosporin, but the verrucous lesions accompanied by chronic bacterial infection persisted over time. One year ago, treatment with recently‐approved apremilast was started. It immediately attenuated the plaques and erythropapular lesions of the trunk. Surprisingly, the verrucous nodules of both legs showed reduction in size in 2 months.