Ustekinumab induces fast response and maintenance of very severe refractory scalp psoriasis: results in two Greek patients from the psoriasis hospital-based clinic.

BACKGROUND: Scalp psoriasis, one of the most common sites of psoriasis involvement, is often difficult to control with topical agents. There is a lack of substantial evidence-based data for the efficacy and safety of systemic therapies. METHODS: Two patients from our university-based psoriasis clinic with chronic plaque psoriasis and severe recalcitrant scalp involvement were assessed by Psoriasis Area and Severity Index and Psoriasis Scalp Severity Index scores, respectively, and quality of life by the Dermatology Life Quality Index. RESULTS: We report 2 psoriasis patients with very severe scalp psoriasis who developed a fast clinical response of scalp psoriasis to ustekinumab in 8 weeks with excellent patient adherence up to 28 weeks of follow-up and positive impact on quality of life due to rapid and long-term clearing. CONCLUSION: Ustekinumab produces a fast clinical response of recalcitrant scalp psoriasis with excellent patient adherence and a positive impact on quality of life due to rapid and long-term clearing in patients with very severe scalp involvement who failed conventional topical and systemic treatment.

Pseudoporphyria associated with nonhemodialyzed renal insufficiency, successfully treated with oral N-acetylcysteine.

Pseudoporphyria (PP) is a relatively rare, photodistributed bullous dermatosis that resembles porphyria cutanea tarda (PCT), but it is not accompanied by porphyrin abnormalities in the serum, urine, or stool. It was initially described in renal failure patients on dialysis. Thereafter, it has been associated with several aetiological factors. We report a case of PP in a 67-year-old woman with mild renal failure, successfully treated with N-acetylcysteine. This is the second reported case of PP developing in nondialyzed chronic renal failure. Such cases support the view that renal impairment itself may play a more important aetiological role in developing PP than it was originally considered.