Juvenile generalized pustular psoriasis treated with etanercept

Authors

  • Jorga Fialová,

    Corresponding author
    1. Deparment of Dermatovenereology, 2nd Medical Faculty, Charles University and Bulovka Hospital, Prague, Czech Republic
    • Address correspondence and reprint requests to: Jorga Fialová, MD, Department of Dermatovenereology, 2nd Medical Faculty, Charles University and Bulovka Hospital, Budínova 2, 180 81 Prague 8, Czech Republic, or email: fialova.jorga@seznam.cz.

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  • Nadežda Vojáčková,

    1. Deparment of Dermatovenereology, 2nd Medical Faculty, Charles University and Bulovka Hospital, Prague, Czech Republic
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  • Daniela Vaňousová,

    1. Deparment of Dermatovenereology, 2nd Medical Faculty, Charles University and Bulovka Hospital, Prague, Czech Republic
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  • Jana Hercogová

    1. Deparment of Dermatovenereology, 2nd Medical Faculty, Charles University and Bulovka Hospital, Prague, Czech Republic
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Abstract

An 8-year-old boy with general pustular psoriasis (GPP) and iatrogenic secondary Cushing syndrome was treated successfully with etanercept after he had failed on acitretin, methotrexate, and methylprednisolone therapy. GPP is a severe and very rare variant of psoriasis in children often accompanied by life-threatening complications. Retinoids, cyclosporine, methotrexate, or dapsone used in a small number of case series and case reports were effective. Etanercept is a recombinant human tumor necrosis factor-alpha (TNF-alpha) receptor protein fused with Fc portion of IgG1 that binds to TNF-alpha, approved by Food and Drug Administration for the treatment of moderate-to-severe plaque psoriasis in children and teens who have not responded to other psoriasis treatments. In our patient, etanercept demonstrated significant clinical response associated with long-term efficacy without acute exacerbation, excellent tolerability, and good safety profile.

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