title: Case presentation of moderate-severe psoriasis.
abstract: The use of biologic agents has greatly improved psoriasis treatment. However, some individuals fail to respond to treatment or loose initial efficacy, and it may be difficult to find the optimal treatment for these patients. We present a patient with long-standing, moderate-severe plaque psoriasis, who had received UVB therapy as well as classical systemic therapies without sufficient response previously. Alefacept only gave a moderate response with quick recurrence after the end of treatment. Adalimumab was working for some time, but finally the patient experienced a slow loss of efficacy and was especially hampered by severe involvement of his hands. This caused him great distress as his work involved a high level of customer contact. The decision was taken to change therapy to ustekinumab. After one injection of ustekinumab psoriasis was greatly improved and it was almost completely resolved after the second injection, and arthritis was no longer active. The efficacy of ustekinumab treatment could be maintained up to now; there is only minimal disease activity and the patient is extremely satisfied. In conclusion, the decision to change to another biologic with different mode of action proved to be successful, and it helped the patient to forget his disease for most of the time and to fulfil the responsibilities of his job.
authors: Department of Dermatology, University of Graz, Graz, Austria. wolfgang.salmhofer@medunigraz.at
authors: W
authors: W
authors: Salmhofer
mesh_terms: D000068879:Adalimumab; D000077944:Alefacept; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011565:Psoriasis / Q000188:drug therapy / Q000473:pathology*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D000069549:Ustekinumab
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents; D011993:Recombinant Fusion Proteins; D000077944:Alefacept; D000069549:Ustekinumab; D000068879:Adalimumab