Erythrodermic Psoriasis Treated with Golimumab: A Case Report

Erythrodermic psoriasis (EP) is a very severe variant of psoriasis whose management poses a challenge to physicians, as currently available therapies often provide unsatisfactory results. Many biologics have been used to treat chronic plaque psoriasis, the most common form of psoriasis; however, their effectiveness for EP is poorly understood. A recently developed biologic, golimumab, has been extensively studied for the treatment of moderate-to-severe active rheumatoid arthritis, psoriatic arthritis, active ankylosing spondylitis, and chronic plaque psoriasis. However, no clinical trials have been performed for EP. Here, we report the case of a 32-year-old man who presented with severe psoriasis that previously failed to respond satisfactorily to methotrexate, cyclosporine, retinoid, narrow-band ultraviolet B phototherapy, and topical agents (i.e., steroids and calcipotriol). Skin lesions worsened progressively and developed into erythroderma. Psoriatic arthritis was also detected. Conventional therapies lacked efficacy. Therefore, we administered golimumab 50 mg. The skin lesions improved significantly according to the Psoriasis Area and Severity Index score after the first administration; lesions improved further throughout the treatment course. Although additional studies are required to fully evaluate the efficacy and safety of golimumab, this agent may be an alternative treatment strategy for some patients with recalcitrant EP.

A Case of Palmoplantar Psoriasis Improved by 308-nm Excimer Laser / 대한피부과학회지

Various modalities have been used for the treatment of psoriasis, including phototherapy. The choice of psoriasis treatment is based on the characteristics of the lesions, locations and amount of involved body surface area. Narrowband ultraviolet (UV) B therapy is a widely used and highly efficient method for psoriasis. But, large areas of unaffected skin may be irradiated along with the psoriatic lesions during phototherapy. The 308-nm excimer laser is a further development of narrowband UVB and was reported to be an effective and safe treatment for localized psoriasis. We experienced an excellent effect without significant adverse reactions of 308-nm excimer laser in a 9-year-old patient with palmoplantar psoriasis who was recalcitrant to oral cyclosporine and topical calcipotriol/betamethasone treatment.