Case Report: Successful Treatment of Acute Generalized Exanthematous Pustulosis With Secukinumab

Frontiers in Medicine

Shifan Ruan¹  Liangliang Zhang¹  Ting Gong¹  Mengting Lin¹  Chengbei Bao¹  Chao Ji¹  Tingting Lin¹  Jing Zhang¹  Qiuyun Xu¹  Tao Liu² 

[1] Department of Dermatology, The First Hospital of Fujian Medical University, Fuzhou, China;Department of Medical Affairs, Beijing Novartis Pharma Company Limited, Shanghai, China;

关键词: AGEP;    secukinumab;    biologic;    interleukin-17A inhibition;    drug eruption;   

DOI  :  10.3389/fmed.2021.758354

来源: DOAJ

【 摘 要 】

Acute generalized exanthematous pustulosis is a severe, usually drug-related reaction, characterized by an acute onset of mainly small non-follicular pustules on an erythematous base. Most cases of acute generalized exanthematous pustulosis (AGEP) clear quickly with a systemic corticosteroid, but severe or recalcitrant cases may need other systemic therapies. In this case, a man in his 40 s with a history of psoriasis consulted a physician about widespread erythema, pustules, target lesions, and fever after the administration of a quadruple antituberculosis drug. Routine laboratory testing revealed elevated white blood cell count and C-reactive protein. The histopathology showed subcorneal pustules, spongiosis as well as lymphocyte and eosinophils infiltration in the dermis. The patient was diagnosed with definitive AGEP according to the diagnostic score from the EuroSCAR study. Cutaneous lesions especially pustules and erythema multiforme-like lesions on the upper arms and palms are crucial for distinguishing AGEP from Generalized pustular psoriasis. The patient was treated with secukinumab as a result of his failure to respond to topical corticosteroids and constrain of systemic steroids. Remission with secukinumab therapy was safe without increased risks of infections. This case indicates that secukinumab is a potential therapy that can rapidly improve the clinical symptoms of AGEP.

【 授权许可】

Unknown