Acute Generalized Pustular Psoriasis Developed Resistance to Adalimumab Was Successfully Treated with Narrowband Ultraviolet B and Acitretin: A Case Report

Overview

Journal Clin Cosmet Investig Dermatol

Publisher Dove Medical Press

Specialty Dermatology

Date 2022 Dec 5

PMID 36466946

Authors

Xianjie Yang

Juan Wang

Huan Wang

Minmin Kong

Qiquann Chen

Affiliations

Soon will be listed here.

Abstract

Acute generalized pustular psoriasis (GPP) is a severe but rare variant of psoriasis, characterized by an acute eruption of extensive erythema with numerous non-follicular pustules. In rare cases, local pustular psoriasis like acrodermatitis continua of Hallopeau (ACH) may progress into acute GPP if improperly treated. ACH and GPP are rare in the clinic and their treatment is more complex and often treatment-resistant compared to psoriasis vulgaris (PV). A variety of anti-psoriasis biologics emerging in recent years have been reported for the treatment of ACH and acute GPP. Biologics is considered to be an upgraded treatment option for traditional anti-psoriasis agents. But there are few reports of GPP patients developing resistance to biologics, or what if biologics fails. Herein, we report a case of acute GPP that developed from ACH, initially responded extremely well to adalimumab, but the treatment failed when the patient treated with the drug again, which is thought to have developed resistance to adalimumab, finally successfully treated with narrowband ultraviolet B (NB-UVB) and acitretin.

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