Treatment of psoriatic erythroderma with biological drugs

Data on the effectiveness of biological therapy in psoriasis vulgaris are well presented in foreign and Russian scientific literature. However, data on generalized forms of the disease are much less. Data on erythrodermic and generalized pustular psoriasis are the least commonly found. The article analyzes articles and clinical guidelines for the management of patients with these severe forms of dermatosis and presents strategies that may help clinicians to determine the therapy for such patients. According to Pubmed, the use of biological drugs in erythrodermic and generalized psoriasis has been analyzed based on clinical reports, case series and uncontrolled open-label studies. A limited number of direct comparative studies or clinical studies on this topic have been identified. In more than half of the cases, data on infliximab are presented based on the described clinical examples. Other biological agents such as etanercept, ustekinumab, adalimumab have also been used in patients with these severe forms of psoriasis. Moreover, there were clinical cases with positive results of therapy in most situations. Secukinumab has been shown to be effective in generalized pustular and palmar-plantar pustular psoriasis in selected clinical trials, while the number of published clinical cases using secukinumab is still small. The availability of updated AAD-NPF international recommendations can be very useful for the validity of the use of these drugs in clinical practice.

psoriatic erythroderma, biological drugs, ifliximab, etanercept, ustekinumab, adalimumab, clinical guidelines, level of evidence