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Granulocyte and monocyte apheresis can control juvenile generalized pustular psoriasis with mutation of IL 36 RN
Author(s) -
Koike Y.,
Okubo M.,
Kiyohara T.,
Fukuchi R.,
Sato Y.,
Kuwatsuka S.,
Takeichi T.,
Akiyama M.,
Sugiura K.,
Utani A.
Publication year - 2017
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.15509
Subject(s) - generalized pustular psoriasis , medicine , psoriasis , apheresis , exacerbation , dermatology , adverse effect , methotrexate , immunology , platelet
Summary Patients with deficiency of interleukin‐36 receptor antagonist ( DITRA ), due to mutation of IL 36 RN , exhibit psoriatic phenotypes, typically generalized pustular psoriasis ( GPP ). We report a paediatric patient with DITRA , whose cutaneous lesions varied from psoriasis vulgaris in infancy to annular pustular psoriasis with acute exacerbation to GPP at 13 years of age. Conventional systemic treatments for GPP , which include oral retinoids, ciclosporin and methotrexate, are controversial in paediatric cases, because of their adverse effects and uncertain long‐term consequences. Granulocyte monocyte apheresis, a process associated with few adverse events, promptly controlled the GPP of our paediatric patient, and has potential as a suitable alternative treatment for paediatric patients with DITRA .