A Case of Recurrent Generalized Pustular Psoriasis Treated with a Combination of Infliximab with Methotrexate and Retinoid / 대한피부과학회지

ABSTRACT

Tumor necrosis factor (TNF)-alpha is suggested to play a major role in the pathophysiology of psoriasis. Excellent clinical responses of psoriasis to anti-TNF-alpha-based therapies have recently been demonstrated. We studied the effect of combination therapy of infliximab, methotrexate, and retinoid in recalcitrant pustular psoriasis. A 34-year-old woman with a 1-year history of severe pustular psoriasis, who had not responded to conventional therapies, responded rapidly to combination treatment with infliximab, methotrexate, and retinoid. The clinical response was ascertained by the PASI gap (Psoriasis area and severity index) and the VAS gap (Visual affected sign). The findings showed that all the pustular lesions faded away after a single combination therapy treatment, and there has been no recurrence of pustular psoriasis for 8 months since initial injection. Thus, we conclude that the combination therapy of infliximab, methotrexate, and retinoid is an effective therapy for severe recalcitrant pustular psoriasis which does not respond to conventional therapies.