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From biologic to biologic to biologic: Lessons to learn for erythrodermic and recalcitrant chronic plaque psoriasis
Author(s) -
Yip Leona,
Harrison Shan,
Foley Peter
Publication year - 2008
Publication title -
australasian journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.67
H-Index - 53
eISSN - 1440-0960
pISSN - 0004-8380
DOI - 10.1111/j.1440-0960.2008.00463.x
Subject(s) - efalizumab , medicine , etanercept , psoriasis , plaque psoriasis , dermatology , infliximab , biologic agents , immunology , tumor necrosis factor alpha , rheumatoid arthritis
SUMMARY Differences in mode of action between biologic agents could explain why one agent is more efficacious than another in the treatment of recalcitrant and erythrodermic flares of chronic plaque psoriasis. Here, we present our experience using a case series of three patients with chronic plaque psoriasis who showed consistent and similar responses to three different biologic agents. All three patients who were refractory to efalizumab developed erythrodermic flares 2–12 weeks after a direct switch to etanercept. Switching from efalizumab to etanercept could provoke paradoxical flaring of psoriasis, which might be prevented by transitioning to systemic agents. The erythrodermic flares in all three patients responded dramatically to infliximab with marked and maintained improvements in Psoriasis Area and Severity Index scores.