Format

Send to

Choose Destination
Br J Dermatol. 2017 Jan;176(1):212-215. doi: 10.1111/bjd.14685. Epub 2016 Oct 12.

Successful response in a case of severe pustular psoriasis after interleukin-1β inhibition.

Author information

1
First Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100, Greece.
2
State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece.
3
Department of Pathology, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100, Greece.
4
Department of Haematology, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100, Greece.
5
Department of Immunology and Histocompatibility, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
6
UF d'Histocompatibilité et Immunogénétique, Département d'Immunologie, Groupe Hospitalier Pitié Salpêtrière - Charles Foix, Paris, France.

Abstract

Generalized pustular psoriasis (GPP) is a severe type of psoriasis accompanied by systemic and often life-threatening manifestations. The efficacy of the interleukin (IL)-1 antagonist anakinra in cases of GPP underscores the role of IL-1 in disease pathogenesis. We present a case of a middle-aged man who developed an abrupt and severe form of GPP with severe eosinophilia and cholestatic hepatitis. The patient received salvage treatment with a combination of glucocorticoids, hydroxyurea and imatinib, while administration of the IL-1 inhibitor anakinra resulted in remission of hepatitis and a significant skin improvement. However, due to persistent hypersensitivity skin reactions, anakinra was withdrawn and replaced with the anti-IL-1β antagonist canakinumab. As a result of canakinumab, the patient's skin completely cleared, while no systemic manifestations recurred. After 1 year of continuous canakinumab therapy, the patient remained virtually free of symptoms, while the drug was well tolerated.

PMID:
27105586
DOI:
10.1111/bjd.14685
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center