Efalizumab-induced guttate psoriasis. Successful management and re-treatment.
Psoriasis is a chronic, immunologically based inflammatory skin disease. Efalizumab (Raptiva) is a humanized monoclonal immunoglobulin G1 antibody that binds with high specificity and affinity to the alpha subunit of leucocyte function-asssociated antigen-1 (LFA-1) on the surface of T cells. Therefore, efalizumab is an effective biologic therapy for the long-term treatment of chronic moderate-to-severe plaque psoriasis. This drug demonstrated a good safety profile, whereas most adverse events were mild to moderate in severity. During efalizumab treatment, a small percentage of patients experienced protocol-defined psoriasis adverse events (e.g. worsening of psoriasis or the onset of new psoriasis morphologies). We present the case of a patient who experienced a new onset of guttate psoriasis and a mild worsening of pre-existing psoriatic lesions during treatment with efalizumab. Restarting with the same drug did not induce any adverse events.
Department of Dermatology, University of Naples Federico II, Naples, Italy. annabalato@yahoo.it
Anna
A
Balato
Serena
S
La Bella
Francesca
F
Gaudiello
Nicola
N
Balato
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D007279:Injections, Subcutaneous; D008297:Male; D011565:Psoriasis / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007155:Immunologic Factors; C472181:efalizumab