Galluzzo M, D'Adamio S, Campione E, Mazzilli S, Bianchi L, Talamonti M
a Department of Dermatology , University of Rome "Tor Vergata" , Viale Oxford 81 , 00133 Rome , Italy.
J Dermatolog Treat. 2018 Sep 26:1-11. doi: 10.1080/09546634.2018.1524818.
Erythrodermic psoriasis is a severe variant of psoriasis characterized by prominent erythema, affecting the entire body surface. Management of erythrodermic psoriasis is difficult, not standardized, and often ineffective. As clinical studies are lacking, reporting of clinical experience with secukinumab may help to gather insight in this field. Here, we describe the case of a 55-year-old man, with a 10-year history of moderate-to-severe plaque psoriasis. He presents a flare of erythroderma involving approximately 90% of his body surface area and a Psoriasis Area and Severity Index score of 42, with an important impact on his quality of life (DLQI score was 20.0; Skindex-29 score was 67.2). The patient presented also alexithymic features. Due to severity of clinical features and poor quality of life, the patient started secukinumab treatment; we observed a striking and rapid response to therapy with an excellent safety profile and a satisfactory compliance. Furthermore, therapy with secukinumab considerably enhanced patient's quality of life. Although further studies are needed to better understand the role of the IL-23/Th17 pathway, secukinumab can be an effective therapeutic option for patients affected by erythrodermic psoriasis.
红皮病型银屑病是银屑病的一种严重变体，其特征为显著红斑，累及全身皮肤表面。红皮病型银屑病的治疗困难、缺乏标准化且常常无效。由于缺乏临床研究，报告司库奇尤单抗的临床经验可能有助于深入了解该领域。在此，我们描述一名55岁男性的病例，他有10年中度至重度斑块状银屑病病史。他出现了红皮病发作，累及身体表面积约90%，银屑病面积和严重程度指数评分为42，对其生活质量有重要影响（皮肤病生活质量指数评分为20.0；皮肤病特异性生活质量指数评分为67.2）。该患者还表现出述情障碍特征。由于临床症状严重且生活质量差，患者开始接受司库奇尤单抗治疗；我们观察到治疗反应显著且迅速，安全性良好且依从性令人满意。此外，司库奇尤单抗治疗显著提高了患者的生活质量。尽管需要进一步研究以更好地理解白细胞介素-23/辅助性T细胞17通路的作用，但司库奇尤单抗可为红皮病型银屑病患者提供一种有效的治疗选择。
