Generalised pustular psoriasis induced by cyclosporin a withdrawal responding to the tumour necrosis factor alpha inhibitor etanercept

Publication

Generalised pustular psoriasis induced by cyclosporin a withdrawal responding to the tumour necrosis factor alpha inhibitor etanercept

Journal Paper/Review - Jan 1, 2002

Kamarashev J, Lor P, Forster A, Heinzerling Lucie, Burg G, Nestle F O

Units

Dermatologie | Venerologie | Allergologie

PubMed

12218252

Citation

Kamarashev J, Lor P, Forster A, Heinzerling L, Burg G, Nestle F. Generalised pustular psoriasis induced by cyclosporin a withdrawal responding to the tumour necrosis factor alpha inhibitor etanercept. Dermatology (Basel, Switzerland) 2002; 205:213-6.

Type

Journal Paper/Review (English)

Journal

Dermatology (Basel, Switzerland) 2002; 205

Publication Date

Jan 1, 2002

Issn Print

1018-8665

Pages

213-6

Brief description/objective

We report a 50-year-old male patient with a 15-year history of psoriasis including mutilating psoriatic arthritis, in whom the withdrawal of cyclosporin A induced a generalised pustular exacerbation and a aggravation of the joint condition. Two weekly injections of 25 mg of the tumour necrosis factor alpha inhibitor etanercept led to a rapid improvement of his psoriatic arthritis, as well as regression of the pustular eruption, while residual erythema was still present. The clinical response was reflected by an increase in circulating interleukin (IL) 10 and a decrease in IL-6 and IL-8 serum levels during treatment. We conclude that etanercept may be a safe and effective therapy not only in severe psoriatic arthritis, but also in cases of pustular rebound after withdrawal of immunosuppressive agents.