Treatment of Two Patients with Erythrodermic Psoriasis with Ixekizumab During COVID-19 Pandemic

Erythrodermic psoriasis (EP) is the most severe form of psoriasis. Here, we report two cases of EP who achieved Psoriasis Area and Severity Index (PASI) 100 with the treatment of ixekizumab during Coronavirus disease-19 (COVID-19) pandemic. A female and a male patient with EP applied to dermatology outpatient clinic of our hospital. Treatment with standard dose ixekizumab (160 mg sc at week 0 and then 80 mg sc every 2 weeks for 12 weeks) led to PASI 100 response in our first case after only 5 weeks and in our second case after 6 weeks. To date, there have been six patients with EP who reached PASI 100 with ixekizumab treatment, one of them could achieve to this level earliest at week 6, one of them earliest at week 8 and four of them earliest at week 12, whereas our first case reached PASI 100 at week 5 and our second case reached at week 6. Our cases were deemed worthy of presentation because our female patient was the case with the fastest response to PASI 100 with ixekizumab, and our two cases were the first reported patients who reached PASI 100 during COVID-19 pandemic. Our patients continue ixekizumab treatment without any side effects and remain self-isolated at home.

Two Patients with Psoriasis and Hepatitis B Treated with Secukinumab During COVID-19 Pandemic

Secukinumab may be a safety option for patients with psoriasis and hepatitis B virus (HBV) infection because of its treatment mechanism. Two patients with chronic HBV who had used tenofovir disoproxil 245 mg per day were suffering from psoriasis. For one, on July 31, 2019 treatment with standard dose secukinumab was started and for another on January 20, 2020. Although on March 11, 2020 Coronavirus disease-2019 (COVID-19) pandemic started in Turkey, we didn’t stop secukinumab treatments of our patients. Based on the start of treatment of secukinumab of our 50-year-old patient, after eight weeks Psoriasis Area Severity Index (PASI) 90 response and after 15 weeks PASI 100 response was reached and PASI 90 response was obtained in our 35-year-old patient after five weeks and PASI 100 response was reached after 18 weeks after starting secukinumab. Secukinumab treatments of our patients are going on. Further long-term studies and case reports are needed to validate the safety and efficacy of secukinumab in patients with HBV. Our cases were deemed worthy of presentation because they were the first reported cases with psoriasis and HBV infection used secukinumab and tenofovir disoproxil in COVID-19 pandemic.