Megna Matteo, Ruggiero Angelo, Camela Elisa, Fabbrocini Gabriella, Marasca Claudio
Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy.
Dermatol Ther. 2020 Mar;33(2):e13238. doi: 10.1111/dth.13238. Epub 2020 Feb 6.
Erythrodermic psoriasis (EP) is the most severe form of psoriasis, resulting in significant morbidity and mortality. EP treatment with biologics is not well ruled by international guidelines, so most biological drugs are used basing on case reports or small case series. Guselkumab, a fully human anti-interleukin (IL)-23 monoclonal antibody, is approved for moderate to severe plaque psoriasis while its use in EP is off label. To date, no case reports on Caucasian patients have been described in the literature. We report the case of 38-year-old Caucasian male with EP successfully treated with guselkumab, reaching PASI 100 after 20 weeks of therapy and still maintaining this response at Week 48. Our case report suggests guselkumab as an efficacious and well-tolerated treatment in EP, presenting a long-term efficacy in the prevention of recurrences. Further studies are warrant to confirm our data, with controlled trials specifically dedicated to EP being strictly needed in order to verify the role and efficacy of anti-IL23 in EP.
红皮病型银屑病（EP）是银屑病最严重的形式，会导致显著的发病率和死亡率。国际指南对使用生物制剂治疗EP的规定并不完善，因此大多数生物药物的使用是基于病例报告或小病例系列。古塞库单抗是一种全人源抗白细胞介素（IL）-23单克隆抗体，已被批准用于治疗中度至重度斑块状银屑病，但其在EP中的使用属于超适应证用药。迄今为止，文献中尚未有关于白人患者的病例报告。我们报告了1例38岁白人男性EP患者，使用古塞库单抗成功治疗，治疗20周后达到银屑病面积和严重程度指数（PASI）100，在第48周时仍维持这一疗效。我们的病例报告表明，古塞库单抗在EP治疗中有效且耐受性良好，在预防复发方面具有长期疗效。需要进一步研究来证实我们的数据，特别需要专门针对EP的对照试验，以验证抗IL-23在EP中的作用和疗效。
