Dermatology, National Skin Centre, 1 Mandalay Road, Singapore 308205.
Australas J Dermatol. 2010 Feb;51(1):29-31. doi: 10.1111/j.1440-0960.2009.00588.x.
Generalized pustular psoriasis of von Zumbusch is an unstable, inflammatory form of psoriasis, with the hallmark of neutrophil infiltration in cutaneous as well as extracutaneous lesions. It is often recalcitrant, making treatment difficult. Tumour necrosis factor-alpha antagonists including infliximab have been used with success in treating recalcitrant cases. We report a case of a 48-year-old Chinese female patient with a long-standing history of poorly controlled generalized pustular psoriasis which was resistant to multiple therapies. During a severe flare, a single dose of infliximab resulted in rapid clearing of cutaneous lesions, together with resolution of liver function abnormalities that are likely secondary to neutrophilic cholangitis. Subsequent maintenance therapy with acitretin allowed remission of pustular disease for 7 months. This demonstrates the efficacy of single-dose infliximab for both cutaneous lesions and systemic hepatic involvement in generalized pustular psoriasis.
von Zumbusch 泛发性脓疱型银屑病是一种不稳定的、炎症性银屑病形式，其特征是皮肤和皮肤外病变中有中性粒细胞浸润。它通常是难治性的，使得治疗变得困难。肿瘤坏死因子-α拮抗剂，包括英夫利昔单抗，已成功用于治疗难治性病例。我们报告了一例 48 岁的中国女性患者，她患有长期未控制的泛发性脓疱型银屑病，对多种治疗方法均有耐药性。在一次严重的发作中，单次使用英夫利昔单抗迅速清除了皮肤病变，并解决了可能继发于中性粒细胞性胆管炎的肝功能异常。随后用阿维 A 酯进行维持治疗，使脓疱性疾病缓解了 7 个月。这表明单次英夫利昔单抗治疗对泛发性脓疱型银屑病的皮肤病变和全身肝脏受累均有效。
