A case of generalized pustular psoriasis: Successful treatment with Ustekinumab = A case of generalized pustular psoriasis: Successful treatment with Ustekinumab

다국어 초록 (Multilingual Abstract)

Generalized pustular psoriasis is a rare, disabling variantof psoriasis. Its treatment is often challenging, as an unsatisfactory response is frequent. There are no universally accepted guidelines for management. Ustekinumab, a fully human monoclonal antibody that binds to the shared p40 subunit of interleukin 12/23, has proven to be effective and safe for the treatment of moderate-to-severe plaque-type psoriasis. We report our experience of generalized pustular psoriasis treatment with ustekinumab. A 43-year-old female presented with recurrent episodes of widespread and often generalized flares of psoriasis for 2 years. She was treated with topical steroids and calcipotrol, cyclosporine, methotrexate, acitretin, etanercept and narrow-band UVB phototherapy, showed only partial response. Physical examination revealed the extensive erythematous patches with pustules over the entire body. A biopsy showed the characteristic findings of pustular psoriasis. The patient started treatment with ustekinumab, according to a pre-established protocol. A 45mg dose of ustekinumab was administered subcutaneously, followed by a 45mg dose 4 and 12 weeks later. Positive response to ustekinumab were initially seen in 2-3 weeks after the first dose. In 4 weeks, the patient achieved a excellent improvement of the skin. We suggest that ustekinumab could be a potentially effective treatment option for pustular psoriasis refractory to conventional therapies.