title: Effective management of psoriasis symptom worsening during efalizumab therapy without discontinuing treatment: a case study.
abstract: Efalizumab is an effective therapy for the long-term treatment of chronic plaque psoriasis. However, regardless of the type of antipsoriatic treatment a patient is receiving, natural fluctuations in symptom severity occur throughout the course of the disease, and need to be managed appropriately. Here, we report the case of a patient with moderate chronic plaque psoriasis resistant to conventional treatments, who initially showed an excellent response to efalizumab (1 mg/kg per week, subcutaneous injection), but then experienced symptom exacerbation after 8 weeks of treatment. This worsening of symptoms was successfully controlled using a short course of concomitant methotrexate treatment (15 mg/week, intramuscular injection). After 1 month, the clinical signs had cleared, methotrexate treatment was stopped and efalizumab therapy was continued. These results show the effective use of a short course of concomitant methotrexate to control fluctuations in psoriasis severity in a patient receiving efalizumab therapy in general clinical practice.
authors.affiliation: Department of Biomedical and Surgical Science, Dermatology Section, University of Verona, Verona, Italy. paolo.gisondi@medicina.univr.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Gisondi
authors.forename: Micol Del
authors.initials: MD
authors.lastname: Giglio
authors.forename: Giampiero
authors.initials: G
authors.lastname: Girolomoni
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006801:Humans; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011565:Psoriasis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents; C472181:efalizumab; D008727:Methotrexate