Ruggiero Angelo, Lauro Wanda, Fabbrocini Gabriella, Miano Chiara, Villani Alessia, Marasca Claudio
Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy.
Case Rep Dermatol. 2022 May 30;14(2):138-143. doi: 10.1159/000523756. eCollection 2022 May-Aug.
Circinate (Lapière) psoriasis represents a rare variety of generalized subacute pustular psoriasis clinically characterized by rapid onset of annular circinate lesions with micro-pustules at the borders without classic plaque psoriasis manifestations. Most reported cases have been described in childhood with a relative benign course, fast and long-term remission after treatment. However, the recalcitrant course may result in an important negative impact on patients' quality of life. Many systemic treatments have been reported for the management of moderate to severe forms, with variable clinical outcomes. However, data about the use of biologics in this rare psoriasis subtype are still lacking. Herein, we report the first case of circinate psoriasis unresponsive to methotrexate and almost all classes of biologics approved for psoriasis (anti-tumour necrosis factor (TNF), anti-interleukin (IL)-12/23, and anti-IL-17) which was successfully treated with risankizumab (anti-IL-23).
环状（拉皮埃尔）银屑病是一种罕见的泛发性亚急性脓疱型银屑病，临床特征为环形环状皮损迅速出现，边界有微脓疱，无经典斑块状银屑病表现。大多数报道的病例见于儿童期，病程相对良性，治疗后缓解迅速且持久。然而，顽固的病程可能会对患者的生活质量产生重大负面影响。已有许多全身治疗方法用于治疗中度至重度形式的环状银屑病，临床疗效各异。然而，关于在这种罕见的银屑病亚型中使用生物制剂的数据仍然缺乏。在此，我们报告了首例对甲氨蝶呤以及几乎所有已批准用于银屑病的生物制剂类别（抗肿瘤坏死因子（TNF）、抗白细胞介素（IL）-12/23和抗IL-17）均无反应的环状银屑病病例，该病例用司库奇尤单抗（抗IL-23）成功治疗。
