E.V. Vladimirova
Academy of postgraduate education under Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of Russia
S.V. Murakov
Academy of Postgraduate Education under Federal Scientific and Clinical Center of Federal Medical-Biological Agency of Russia
Yu.A. Markova
Department of skin and venereal diseases with cosmetology course Federal state budgetary educational institution of additional professional education Institute of advanced training of Federal medical and biological Agency
E.V. Matushevskaya
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA
A.P. Bezugly
Academy of Postgraduate Education under Federal Scientific and Clinical Center of Federal Medical-Biological Agency of Russia
N.S. Sirmays
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies of the Federal Medical Agency;
Centre of Modern paediatrics
Ya.A. Petinati
Academy of Postgraduate Education under Federal Scientific and Clinical Center of Federal Medical-Biological Agency of Russia
Acute generalized pustular psoriasis (Zumbusch type): successful treatment without biologics
Journal: Russian Journal of Clinical Dermatology and Venereology. 2023;22(1): 26‑32
Views: 6445
Downloaded: 170
To cite this article:
Vladimirova EV, Murakov SV, Markova YuA, Matushevskaya EV, Vladimirov AA, Kapuler OM, Bezugly AP, Sirmays NS, Petinati YaA. Acute generalized pustular psoriasis (Zumbusch type): successful treatment without biologics. Russian Journal of Clinical Dermatology and Venereology.
2023;22(1):26‑32. (In Russ., In Engl.)
https://doi.org/10.17116/klinderma20232201126
Psoriasis is a chronic inflammatory disease predominantly affecting the skin. Acute generalized pustular psoriasis (GPP) is one of the rarest and most severe types of psoriasis. GPP manifests as spontaneously occurring specific skin lesions and is accompanied by a worsening of the general condition (fever, chills, malaise, nausea, severe pain, joint pain). Among the factors provoking pustular psoriasis are abrupt withdrawal of systemic steroid drugs, pregnancy, hypocalcemia, upper respiratory tract infections, and mental disorders. The main pathophysiological mechanism of the occurrence and progression of GPP is the migration of polymorphonuclear leukocytes from the vascular wall into the tissues and the activation of interleukins and nonspecific cytokines. Acitretin, cyclosporine, and methotrexate are used as first-line therapy. In addition, retinoids are also used in the basic therapy of various types of psoriasis. Second-line therapy includes adalimumab, etanercept, PUVA therapy, topical corticosteroids, and topical calcipotriol. The UK National Institute for Health and Clinical Excellence (NICE) has issued guidelines on non-biological therapies.
A clinical case of Zumbusch-type GPP in a 25-year-old patient with a history of the disease since 3 years old is described.
Treatment included cyclosporine A in the first phase and the combination of retinoids with total PUVA therapy in the second phase.
This treatment method made it possible to achieve 100% regression of the rash and ensure the absence of relapses without expensive biologicals.
The results suggest that effective treatment of acute GPP (Zumbusch type) is possible without biological therapy.
Authors:
E.V. Vladimirova
Academy of postgraduate education under Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of Russia
S.V. Murakov
Academy of Postgraduate Education under Federal Scientific and Clinical Center of Federal Medical-Biological Agency of Russia
Yu.A. Markova
Department of skin and venereal diseases with cosmetology course Federal state budgetary educational institution of additional professional education Institute of advanced training of Federal medical and biological Agency
E.V. Matushevskaya
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA
A.P. Bezugly
Academy of Postgraduate Education under Federal Scientific and Clinical Center of Federal Medical-Biological Agency of Russia
N.S. Sirmays
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies of the Federal Medical Agency;
Centre of Modern paediatrics
Ya.A. Petinati
Academy of Postgraduate Education under Federal Scientific and Clinical Center of Federal Medical-Biological Agency of Russia
Received:
03.08.2022
Accepted:
14.11.2022
List of references:
Close metadata
Email Confirmation
An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.
Email Confirmation
Log in to the site using your account in one of the services
We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.