Erythrodermic Psoriasis: Current and Future Role of Biologicals

Stinco, Giuseppe; Errichetti, Enzo

doi:10.1007/s40259-015-0119-4

Cited by 26 publications

(39 citation statements)

References 58 publications

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“…2 When associated with psoriasis, the erythrodermic variant represents less than 1.5% of cases and manifests with well-defined erythematous plaques and overlying silvery scale. 3 It generally affects the entire body and may be associated with life-threatening complications such as sepsis, hypovolemic shock, and acute kidney injury secondary to cutaneous fluid loss.…”

Section: Discussionmentioning

confidence: 99%

“…3 It generally affects the entire body and may be associated with life-threatening complications such as sepsis, hypovolemic shock, and acute kidney injury secondary to cutaneous fluid loss. 2 Erythrodermic psoriasis may result from uncontrolled dermatosis, abrupt withdrawal of anti-psoriatic drugs such as steroids or methotrexate, drug reaction, systemic infection, ultraviolet burns, alcoholism, and emotional stress. 2 Our patient’s withdrawal from oral steroids likely triggered his erythroderma.…”

Section: Discussionmentioning

confidence: 99%

“…2 Erythrodermic psoriasis may result from uncontrolled dermatosis, abrupt withdrawal of anti-psoriatic drugs such as steroids or methotrexate, drug reaction, systemic infection, ultraviolet burns, alcoholism, and emotional stress. 2 Our patient’s withdrawal from oral steroids likely triggered his erythroderma. Skin biopsy may be helpful in diagnosis as erythroderma may develop acutely or gradually from any variant of psoriasis.…”

Section: Discussionmentioning

confidence: 99%

“…Skin biopsy may be helpful in diagnosis as erythroderma may develop acutely or gradually from any variant of psoriasis. 2 Treatment is largely based on aggressive supportive care and the use of anti-inflammatory immunosuppressive and biologic agents. High quality evidence-based treatment recommendations for erythordermic psoriasis are lacking due to the rarity of the condition.…”

Section: Discussionmentioning

confidence: 99%

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Erythrodermic psoriasis treated with apremilast

et al. 2016

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Erythroderma is a rare potentially deadly exfoliative dermatitis characterized by diffuse cutaneous erythema which may be associated with multi-organ dysfunction. Therefore, it is imperative to recognize and treat it promptly. Erythrodermic psoriasis is the most common form of erythroderma. Management of this condition is largely based on aggressive supportive care and the use of anti-inflammatory immunosuppressive and biologic agents. We describe a case of psoriatic erythroderma which was triggered by withdrawal from systemic steroids and successfully treated with apremilast and cyclosporine. Apremilast induced atrial fibrillation limited its continued use after the initial response period.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Erythrodermic psoriasis treated with apremilast

et al. 2016

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“…Both the efficacy and safety of conventional therapeutic options are unsatisfactory. Studies regarding the use of biological agents in EP were limited to few case series (11). Results suggested that anti-psoriatic biological agents targeting the IL-23/Th17 pathway, including anti-IL23p19 antibodies (tildrakizumab and guselkumab), and anti-IL17 agents (secukinumab, ixekizumab, and brodalumab) might play a positive role in the therapy of EP (12,13).…”

Section: Secukinumab Treatment In Psoriatic Patients: Italian Experiementioning

confidence: 99%

Secukinumab treatment in psoriatic patients: Italian experiences

Idolazzi

2018

Journal of Dermatological Treatment

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Ustekinumab is effective and safe in the long‐term treatment of erythrodermic psoriasis: Multicenter study in daily practice

Plana,

Concha‐Garzón,

Rocamora

et al. 2024

JEADV Clinical Practice

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BackgroundThe treatment of erythrodermic psoriasis (EP) is challenging. Biological therapies have shown promising results in the long‐term management of this clinical variant, but most of the current available evidence is based on single case reports and short case series.ObjectivesTo determine the effectiveness and safety of ustekinumab (UST) in the treatment of EP under daily practice conditions.MethodsWe conducted a retrospective, observational, nationwide, multicenter cohort study of patients diagnosed with EP treated with UST under daily practice conditions with up to 3 years of follow‐up. Outcomes, such as the psoriasis area and severity index (PASI) and safety, were assessed at months 1, 4, 7, 13, 19, 25, 31 and 37 during treatment. “As observed” and “intention‐to‐treat last observation carried forward (ITT‐LOCF)” analyses were performed.ResultsTwenty‐eight patients were enroled in the study. Baseline mean PASI was 43.1. A sharp decrease in mean PASI was observed during the first 7 months, reaching a plateau that was maintained until the end of the 37‐month follow‐up. At 7 months, 61% and 43% of the patients achieved PASI ≤ 2 and PASI 0, respectively. At 25 months, 48 (39%) (“as observed”/ITT‐LOCF) of the patients achieved complete clearance. At 31 months, PASI 75, PASI 90 and PASI 100 were achieved in 95, 80 and 45 (79%, 64% and 39%) (“as observed”/ITT‐LOCF) of the patients, respectively. Eleven patients required treatment intensification by reducing the interval between doses. Treatment minimisation was performed in four patients. During the follow‐up, nine patients (32%) received systemic combination therapy at some point. Eight patients discontinued treatment mainly due to lack of effectiveness. UST presented a good safety profile. With a follow‐up of 69.25 patient/years, only three patients exhibited serious nondrug‐related adverse events.ConclusionsUstekinumab can be a fast, effective and safe alternative for the long‐term treatment of erythrodermic psoriasis.

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Erythrodermic Psoriasis: Current and Future Role of Biologicals

Cited by 26 publications

References 58 publications

Erythrodermic psoriasis treated with apremilast

Erythrodermic psoriasis treated with apremilast

Secukinumab treatment in psoriatic patients: Italian experiences

Ustekinumab is effective and safe in the long‐term treatment of erythrodermic psoriasis: Multicenter study in daily practice

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