Home > Proceedings in Dermatology > Proceedings of the 7th IFPA WPPAC > Refractory generalised pustular psoriasis successfully treated with IL-23 inhibitor: a case report

Refractory generalised pustular psoriasis successfully treated with IL-23 inhibitor: a case report

Author(s)
*
Dawei Huang ×Dawei Huang
* Contributed equally
Affiliation
Shanghai skin disease hospital Department of dermatology Shanghai China
*
Jiajing Lu ×Jiajing Lu
* Contributed equally
Affiliation
Shanghai skin disease hospital Department of dermatology Shanghai China
Yi Zhang ×Yi Zhang
Affiliation
Shanghai skin disease hospital Department of dermatology Shanghai China
Shi Yuling (email)×Shi Yuling (orcid) (email)
Affiliation
Professor

Conference
IFPA-WPPAC 2024
Abstract
Generalized pustular psoriasis (GPP) is a rare, severe, potentially life-threatening immune-mediated inflammatory skin disease. The advent of biologics has dramatically changed the management strategy of GPP. However, there is significant heterogeneity in the efficacy of biologics. Here, we report a young female patient who received three biologics that failed. A 33-year-old female patient was diagnosed with GPP, and then she was treated with spesolimab, adalimumab, ixekizumab, and secukinumab administration. Despite receiving treatment with 4 different biologics, the patient exhibited a suboptimal response and persistent presence of pustules. Further histopathological examination and whole-exon sequencing (WES) confirmed the diagnosis of GPP and contained IL23R mutation. Then we treated the patient with guselkumab, and within 12 weeks, the lesions improved rapidly and the pustules cleared. In general, despite the availability of numerous novel treatment options, there still exists a subset of patients who exhibit resistance to various therapeutic interventions. For individuals afflicted with GPP, WES may prove advantageous as it facilitates both diagnosis and treatment decision-making.

* Authors contributed equally.

Keywords
Generalized pustular psoriasis, Whole-exon sequencing, Biologics, Guselkumab

Doi
https://doi.org/10.55788/2d367e82


©2024 the author(s). Published with license by Medicom Medical Publishers.
This an Open Access article distributed under the terms of the Creative Commons attribution-non Commercial license (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


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