|
1
|
Pogorelov D, Tschesche A, Balakirski G, Hofmann SC. Generalized Pustular Psoriasis of Pregnancy Successfully Treated With Certolizumab Pegol: A Case Report and Literature Review. Cureus 2024; 16:e59832. [PMID: 38846233 PMCID: PMC11156444 DOI: 10.7759/cureus.59832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 06/09/2024] Open
Abstract
Generalized pustular psoriasis of pregnancy (GPPP) is a rare dermatological condition that significantly affects maternal health and pregnancy outcomes. The treatment of this disease might be very challenging, as only a limited number of effective therapeutic options are available. If the use of systemic drugs is considered, they should ideally effectively control the systemic inflammation without harming the fetus. Here, we report the successful treatment of a severe case of GPPP in a 28-year-old woman using the tumor necrosis factor-alpha inhibitor (TNFi) certolizumab pegol. Additionally, we review the existing literature on the use of this class of drugs for treating GPPP. To date, there are only 11 reported cases of this severe skin condition treated with a TNFi. We also discuss the pathogenesis of GPPP and the rationale behind using TNFi for its treatment.
Collapse
Affiliation(s)
- Dimitrii Pogorelov
- Center for Dermatology, Allergology and Dermatosurgery, Helios University Hospital Wuppertal, Wuppertal, DEU
| | - Anne Tschesche
- Center for Dermatology, Allergology and Dermatosurgery, Helios University Hospital Wuppertal, Wuppertal, DEU
| | - Galina Balakirski
- Center for Dermatology, Allergology and Dermatosurgery, Helios University Hospital Wuppertal, Wuppertal, DEU
| | - Silke C Hofmann
- Center for Dermatology, Allergology and Dermatosurgery, Helios University Hospital Wuppertal, Wuppertal, DEU
| |
Collapse
|
|
2
|
Reich K, Augustin M, Gerdes S, Ghoreschi K, Kokolakis G, Mößner R, Mrowietz U, Navarini AA, Pinter A, Schäkel K, Staubach P, Sticherling M, Thaçi D, Wilsmann-Theis D. Generalisierte pustulöse Psoriasis: Überblick zum Status quo und Ergebnisse einer Diskussionsrunde. J Dtsch Dermatol Ges 2022; 20:753-772. [PMID: 35711041 DOI: 10.1111/ddg.14764_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/12/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Kristian Reich
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf (UKE)
| | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf (UKE)
| | - Sascha Gerdes
- Psoriasis-Zentrum, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Kamran Ghoreschi
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin und der Humboldt- Universität zu Berlin
| | - Georgios Kokolakis
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin und der Humboldt- Universität zu Berlin
| | - Rotraut Mößner
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Ulrich Mrowietz
- Psoriasis-Zentrum, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | | | - Andreas Pinter
- Klinik für Dermatologie, Venerologie und Allergologie, Goethe-Universität, Frankfurt am Main
| | - Knut Schäkel
- Abteilung für Dermatologie, Universitätsklinikum Heidelberg
| | | | - Michael Sticherling
- Deutsches Zentrum Immuntherapie, Klinik für Dermatologie, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
| | - Diamant Thaçi
- Institut für Entzündungsmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | | |
Collapse
|
|
3
|
Reich K, Augustin M, Gerdes S, Ghoreschi K, Kokolakis G, Mößner R, Mrowietz U, Navarini AA, Pinter A, Schäkel K, Staubach P, Sticherling M, Thaçi D, Wilsmann-Theis D. Generalized pustular psoriasis: overview of the status quo and results of a panel discussion. J Dtsch Dermatol Ges 2022; 20:753-771. [PMID: 35674482 DOI: 10.1111/ddg.14764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/12/2022] [Indexed: 11/27/2022]
Abstract
Generalized pustular psoriasis (GPP) is a rare, severe, potentially life-threatening, autoinflammatory, neutrophilic skin disease that may be accompanied by fever and leukocytosis. This paper describes the current state of knowledge on GPP in terms of classification, (differential) diagnosis and prevalence. We present a comparison of the genetics and pathoimmunology of GPP and psoriasis vulgaris with the central mechanisms of autoimmunology and autoinflammation. The currently available therapeutic options, expert recommendations for therapy, and data from early clinical trials investigating targeted therapies will be summarized. We present the results of our discussion with 13 experts for psoriasis vulgaris and GPP and give an integrated overview of indication and therapy based on our personal experience and present an outlook on further research questions. Collectively, this article highlights the high unmet need in GPP, as there exists no satisfactory method of diagnosis or treatment to date and new treatment options will be of great therapeutic benefit to those affected.
Collapse
Affiliation(s)
- Kristian Reich
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Sascha Gerdes
- Psoriasis-Center, Clinic for Dermatology, Venereology and Allergology, University Medical Center Schleswig-Holstein/Campus Kiel, Kiel, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Georgios Kokolakis
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Rotraut Mößner
- Department of Dermatology, Venerology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Ulrich Mrowietz
- Psoriasis-Center, Clinic for Dermatology, Venereology and Allergology, University Medical Center Schleswig-Holstein/Campus Kiel, Kiel, Germany
| | | | - Andreas Pinter
- Department of Dermatology, Venereology, and Allergology, Goethe University, Frankfurt am Main, Germany
| | - Knut Schäkel
- Department of Dermatology, Heidelberg University Hospital, Heidelberg, Germany
| | - Petra Staubach
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - Michael Sticherling
- Deutsches Zentrum Immuntherapie, Department of Dermatology, Friedrich- Alexander University, Friedrich-Alexander University, Erlangen-Nuermberg, Erlangen, Germany
| | - Diamant Thaçi
- Institute and Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | | |
Collapse
|