TY - JOUR
T1 - Ustekinumab treatment of pityriasis rubra pilaris
T2 - A report of five cases
AU - Napolitano, Monica
AU - Lembo, Luigi
AU - Fania, Luca
AU - Abeni, Damiano
AU - Didona, Dario
AU - Didona, Biagio
PY - 2017/10/28
Y1 - 2017/10/28
N2 - Pityriasis rubra pilaris (PRP) is a rare, chronic, inflammatory skin disease of unknown etiology. Patients refractory to conventional therapies have been treated successfully with biologic drugs such as anti-tumor necrosis factor agents. Recently, a role of the interleukin-23/T-helper 17 axis in PRP has been described. Our objective was to assess the effectiveness of ustekinumab in five patients with adult-onset PRP refractory to conventional therapies. In the present study, four patients had type I and one patient type II adult-onset PRP. They were treated with three s.c. doses of ustekinumab at weeks 0, 4 and 16. Clinical response was evaluated monthly during treatment up to a 15-month follow-up period. All patients promptly showed a decrease in erythema, follicular hyperkeratosis and scaling. After three injections, complete remission of skin lesions was achieved in four out of five cases and a significant clinical improvement was shown in one case. To the best of our knowledge, this is the largest case series reported on ustekinumab treatment in PRP. Our results, in addition to previous studies from other groups, suggest that ustekinumab may be a possible first-line treatment for PRP patients refractory to conventional therapies.
AB - Pityriasis rubra pilaris (PRP) is a rare, chronic, inflammatory skin disease of unknown etiology. Patients refractory to conventional therapies have been treated successfully with biologic drugs such as anti-tumor necrosis factor agents. Recently, a role of the interleukin-23/T-helper 17 axis in PRP has been described. Our objective was to assess the effectiveness of ustekinumab in five patients with adult-onset PRP refractory to conventional therapies. In the present study, four patients had type I and one patient type II adult-onset PRP. They were treated with three s.c. doses of ustekinumab at weeks 0, 4 and 16. Clinical response was evaluated monthly during treatment up to a 15-month follow-up period. All patients promptly showed a decrease in erythema, follicular hyperkeratosis and scaling. After three injections, complete remission of skin lesions was achieved in four out of five cases and a significant clinical improvement was shown in one case. To the best of our knowledge, this is the largest case series reported on ustekinumab treatment in PRP. Our results, in addition to previous studies from other groups, suggest that ustekinumab may be a possible first-line treatment for PRP patients refractory to conventional therapies.
KW - erythroderma
KW - interleukin-23
KW - pityriasis rubra pilaris
KW - retinoids
KW - ustekinumab
UR - http://www.scopus.com/inward/record.url?scp=85032279272&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85032279272&partnerID=8YFLogxK
U2 - 10.1111/1346-8138.14114
DO - 10.1111/1346-8138.14114
M3 - Article
AN - SCOPUS:85032279272
VL - 45
SP - 202
EP - 206
JO - Journal of Dermatology
JF - Journal of Dermatology
SN - 0385-2407
IS - 2
ER -