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Excellent response to secukinumab in an infant with severe generalized pustular psoriasis
Author(s) -
LópezSánchez Cristina,
Falla Lina María,
RoéCrespo Esther,
Arostegui Juan Ignacio,
Mozos Ana,
Bernal Sara,
Iznardo Helena,
BaselgaTorres Eulalia
Publication year - 2021
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 - 10.1111/1346-8138.15673
Subject(s) - generalized pustular psoriasis , secukinumab , medicine , acitretin , dermatology , anakinra , psoriasis , immunology , disease , pediatrics , psoriatic arthritis
Generalized pustular psoriasis (GPP) represents the rarest form of psoriasis, which may be potentially fatal. In the last decade, (likely) pathogenic variants in the IL36RN , CARD14 and AP1S3 genes have been associated with monogenic GPP forms. Despite these advances, the genetic basis of most patients with GPP remains unidentified. Treatment of GPP patients is often difficult, with no consensus about the best available options to date. We report herein an infant with severe GPP in whom the disease started at the age of 2 months. Genetic investigations identified a heterozygous pathogenic variant in the IL36RN gene associated with a heterozygous variant of uncertain significance in the CARD14 gene. After previous treatment failures with acitretin, cyclosporin and anakinra, treatment with the interleukin‐17 antagonist secukinumab resulted in a dramatic and prompt positive response that persisted at 12‐month follow up. According to our experience, we believe secukinumab can be an effective and safe treatment for pediatric patients with GPP even before 1 year of age.