Long-term efficacy of adalimumab in generalized pustular psoriasis

Background: Generalized pustular psoriasis (GPP) is a rare form of psoriasis that may either be preceded by plaque psoriasis or arise de novo, classically after withdrawal of systemic glucocorticosteroids. Adalimumab is a fully human, anti-TNF-alpha monoclonal antibody that specifically blocks the interaction of TNF-alpha with the p55 and the p75 TNF-alpha cell surface receptors. Aim: To demonstrate the efficacy and tolerability of adalimumab in the treatment of GPP. Case report: A 50-year-old woman had suffered from severe pustular psoriasis for 10 years and psoriatic arthritis for 8 years and received treatment with adalimumab, in monotherapy, 40 mg subcutaneously once a week for 72 weeks. DLQI, PDI and SKINDEX 29 score were used to assess patient compliance and satisfaction. Results: In our case, control of disease manifestations was rapid and clinical remission persisted during the treatment course until the 72th week. Treatment tolerability and compliance were consistent. The patient experienced a dramatic improvement of quality of life instruments. Conclusion: In this case, adalimumab has been demonstrated to be effective, safe and appropriate for long-term use, indicating a beneficial effect on quality of life parameters.