A Case of Pustular Psoriasis Developed during Infliximab Treatment for Crohn's Disease / 대한피부과학회지

ABSTRACT

Infliximab is a monoclonal antibody that binds and inactivates tumor necrosis factor-alpha. It has been successfully used to manage diseases associated with a Th1 profile such as psoriasis, Crohn's disease, and rheumatoid arthritis. A 15-year-old boy presented for erythematous scaly papules and pustules with crust on his entire body, which had appeared initially 2 months ago. He had been treated with infliximab for Crohn's disease during the last 14 months and had not been diagnosed with psoriasis. A skin biopsy specimen demonstrated papulosquamous dermatitis with subcorneal pustule formation, suggestive of pustular psoriasis. The patient was treated with oral retinoid 20 mg/d for 3 weeks and 10 mg/d for next 3 weeks with concurrent topical steroid, and most lesions disappeared completely with post inflammatory hyperpigmentation. No evidence of recurrence has been observed during 3 months of followup.