Keywords
generalized pustular psoriasis; risankizumab; interleukin-23 (IL-23) inhibitors
Disciplines
Dermatology | Pharmacy and Pharmaceutical Sciences
Abstract
Introduction
Psoriasis is a chronic, multifactorial, inflammatory skin disease with several subtypes, including pustular psoriasis. Pustular psoriasis is characterized by pustules forming lakes of pus on the skin. Pro-inflammatory pathways, such as the interleukin (IL)-17/IL-23 axis, have been shown to play a significant role in the pathogenesis of psoriasis. Biologic therapies directed towards these pro-inflammatory pathways have effectively treated plaque psoriasis, but fewer treatments have shown similar efficacy for pustular psoriasis.
Case Presentation
We present a 45-year-old Black female who presented to the dermatology clinic with generalized pustular psoriasis affecting approximately 70% of her body surface area. She also noted joint stiffness and pain that was worse after inactivity. Her disease did not respond to previous treatment, which was using adalimumab for 6 months. She also had no response to a 3-month course of apremilast. Two weeks after receiving her first dose of risankizumab, she had complete clearance of her pustular psoriasis, affecting 0% of her body surface area. She also noted significant improvement in her joint pain.
Conclusions
There is little data regarding the efficacy of IL-23 inhibitors in treating generalized pustular psoriasis. To date, our case is the only reported instance in the literature showing rapid clearance of pustular psoriasis after 1 injection of risankizumab. This case illustrates that IL-23 inhibitors play an essential role in the rapid clearance of pustular psoriasis.
Recommended Citation
Hermann, Ashleigh E. and Weis, Stephen E.
(2023)
"Complete Clearance of Pustular Psoriasis After A Single Dose of Risankizumab,"
HCA Healthcare Journal of Medicine: Vol. 4:
Iss.
2, Article 20.
DOI: 10.36518/2689-0216.1480
Available at:
https://scholarlycommons.hcahealthcare.com/hcahealthcarejournal/vol4/iss2/20