Granulocyte and monocyte apheresis can control juvenile generalized pustular psoriasis with mutation of IL36RN. (1st December 2017)

• Record Type: Journal Article
• Authors: Koike, Y.; Okubo, M.; Kiyohara, T.; Fukuchi, R.; Sato, Y.; Kuwatsuka, S.; Takeichi, T.; Akiyama, M.; Sugiura, K.; Utani, A.
• Is Part Of: British journal of dermatology. Volume 177:Number 6(2017)
• Page Start: 1732
• Page End: 1736
• Publication Date: 2017-12-01
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.15509
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Patients with deficiency of interleukin‐36 receptor antagonist (DITRA), due to mutation of IL36RN, exhibit psoriatic phenotypes, typically generalized pustular psoriasis (GPP). We report a paediatric patient with DITRA, whose cutaneous lesions varied from psoriasis vulgaris in infancy to annular pustular psoriasis with acute exacerbation to GPP at 13 years of age. Conventional systemic treatments for GPP, which include oral retinoids, ciclosporin and methotrexate, are controversial in paediatric cases, because of their adverse effects and uncertain long‐term consequences. Granulocyte monocyte apheresis, a process associated with few adverse events, promptly controlled the GPP of our paediatric patient, and has potential as a suitable alternative treatment for paediatric patients with DITRA.