Erythrodermic Psoriasis Treated with Golimumab: A Case Report.
Erythrodermic psoriasis (EP) is a very severe variant of psoriasis whose management poses a challenge to physicians, as currently available therapies often provide unsatisfactory results. Many biologics have been used to treat chronic plaque psoriasis, the most common form of psoriasis; however, their effectiveness for EP is poorly understood. A recently developed biologic, golimumab, has been extensively studied for the treatment of moderate-to-severe active rheumatoid arthritis, psoriatic arthritis, active ankylosing spondylitis, and chronic plaque psoriasis. However, no clinical trials have been performed for EP. Here, we report the case of a 32-year-old man who presented with severe psoriasis that previously failed to respond satisfactorily to methotrexate, cyclosporine, retinoid, narrow-band ultraviolet B phototherapy, and topical agents (i.e., steroids and calcipotriol). Skin lesions worsened progressively and developed into erythroderma. Psoriatic arthritis was also detected. Conventional therapies lacked efficacy. Therefore, we administered golimumab 50 mg. The skin lesions improved significantly according to the Psoriasis Area and Severity Index score after the first administration; lesions improved further throughout the treatment course. Although additional studies are required to fully evaluate the efficacy and safety of golimumab, this agent may be an alternative treatment strategy for some patients with recalcitrant EP.
Department of Dermatology, Pusan National University Hospital, Busan, Korea.
Won-Ku
WK
Lee
Department of Dermatology, Pusan National University Hospital, Busan, Korea.
Gun-Wook
GW
Kim
Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Hyun-Ho
HH
Cho
Department of Dermatology, Pusan National University Hospital, Busan, Korea.
Won-Jeong
WJ
Kim
Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Je-Ho
JH
Mun
Department of Dermatology, Pusan National University Hospital, Busan, Korea.
Margaret
M
Song
Department of Dermatology, Pusan National University Hospital, Busan, Korea.
Hoon-Soo
HS
Kim
Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea. ; Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea.
Hyun-Chang
HC
Ko
Department of Dermatology, Pusan National University Hospital, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Moon-Bum
MB
Kim
Department of Dermatology, Pusan National University Hospital, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Byung-Soo
BS
Kim
Biological products; Erythrodermic psoriasis; Golimumab; Psoriasis; Psoriatic arthritis