Generalized pustular psoriasis of pregnancy successfully treated with cyclosporine

Abstract

Two multigravidae aged 27 and 29 years, with previous uneventful pregnancies, second being psoriatic, reported at 24 and 28 weeks of pregnancies, with generalized pustular lesions. Laboratory findings, including serum calcium were normal. Ultrasonography showed normal fetal growth. Histopathology confirmed pustular psoriasis. Patients were put on cyclosporine 3 mg/ kg weight/ day after failure of an initial systemic steroid. Blood pressure, pulse, and fetal heart sounds were recorded every 12 hours, and ultrasonography and blood parameters, biweekly. Cyclosporine was tapered and stopped after delivery of two healthy babies at 38 weeks. We conclude that cyclosporine can be an option in the management of pustular psoriasis of pregnancy or psoriasis with pustulation in pregnancy.

Cyclosporine in the Management of Impetigo Herpetiformis: A Case Report and Review of the Literature

“…Cyclosporine has been administered in 13 patients with IH in the literature [6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17]. Reviewing the above-mentioned cases, in 12 out of 14 cases, including ours, cyclosporine was not used as a monotherapy in the treatment of IH but in combination with systemic corticosteroids (table 1).…”

“…It is a rare pustular dermatosis related to pregnancy with no more than 200 reported cases up to now [6]; it may recur in future pregnancies or with menstrual exacerbation [5]. In a significant number of cases, a history of psoriasis is well documented.…”

Pustular psoriasis of pregnancy (Impetigo herpetiformis) - case report

“…3 Currently, some authors use the term "pustular psoriasis of pregnancy"(PPG), based on the fact that the pustules are sterile and do not present viral etiology. 2,3,7,8 …”

Safety of conventional systemic therapies for psoriasis on reproductive potential and outcomes

“…Case studies on the use of ciclosporin for the treatment of generalised pustular psoriasis of pregnancy reported four pregnancies (11,12) and found healthy infants.…”