title: Psoriasis vulgaris flare during efalizumab therapy does not preclude future use: a case series.
abstract: BACKGROUND
  Severe psoriasis vulgaris can be extremely difficult to treat in some patients, even with the newer biological therapies available today.
  
  
  METHODS
  We present two patients with severe chronic plaque psoriasis who received numerous systemic anti-psoriatic therapies with varied results. Both responded well to initial treatment with efalizumab (anti-CD11a), but then experienced a flare of their disease after missing a dose. However, after disease stablization, both patients responded well to re-introduction of efalizumab, one patient requiring concurrent treatment with infliximab (anti-TNF-alpha).
  
  
  CONCLUSIONS
  These cases are presented to characterize this "flare" reaction, and to inform health care providers that efalizumab can still be administered after disease flare, and again may be a successful therapy.
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA. lowesm@rockefeller.edu
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Lowes
authors.forename: James A
authors.initials: JA
authors.lastname: Turton
authors.forename: James G
authors.initials: JG
authors.lastname: Krueger
authors.forename: Ross St C
authors.initials: RS
authors.lastname: Barnetson
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D015535:Arthritis, Psoriatic / Q000188:drug therapy; D018845:CD11 Antigens; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D016169:Lymphocyte Function-Associated Antigen-1 / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology; D055502:Secondary Prevention
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018845:CD11 Antigens; D007155:Immunologic Factors; D016169:Lymphocyte Function-Associated Antigen-1; C472181:efalizumab