Short-term effectiveness of biologic therapy for erythrodermic psoriasis: A single-center study

Abstract Background: Erythrodermic psoriasis (EP) is a severe and rare subtype of psoriasis, characterized by generalized desquamation and erythema covering more than 75% of the body surface area (BSA). Although biologic therapy has shown effectiveness in moderate-to-severe plaque psoriasis, studies on its efficacy and safety in EP remain limited. Objectives: We aimed to examine the short-term effectiveness of biologic therapy in patients with erythrodermic psoriasis (EP) in real-world settings at 4 and 8 weeks of treatment. Methods: Data on the patients’ baseline and follow-up characteristics, including outcomes, were extracted from their medical records at the Dermatology Department of the People’s Hospital of Xinjiang Uygur Autonomous Region (March 2020–June 2023). Descriptive analyses were performed. Normally distributed continuous variables were expressed as the mean ± standard deviation, while nonnormally distributed variables were expressed as the median and interquartile range. Wilcoxon signed-rank test and one-way analysis of variance were used to compare disease severity before and after treatment. Results: A total of 12 patients with EP were enrolled, including six men and six women, with a mean age of 36.42 ± 21.3 years. Three patients were treated with adalimumab, six with secukinumab, two with ixekizumab, and one with guselkumab. The Psoriasis Area and Severity Index (PASI), body surface area (BSA), Dermatology Life Quality Index (DLQI), and Physician Global Assessment (PGA) scores were significantly lower at weeks 4 and 8 than at baseline (week 0), suggesting treatment effectiveness. At week 4, five patients reached PASI90. At week 8, five patients reached PASI100, 11 reached PGA 0/1, and eight reached DLQI 0/1. Bonferroni-corrected pairwise comparisons indicated significant differences in the BSA, PASI, DLQI, and PGA scores between weeks 0 and 4 and in the BSA scores between weeks 4 and 8, but not in the PASI, DLQI, and PGA scores between weeks 4 and 8. No patient developed serious adverse reactions (e.g., infection or tumors). Conclusion: These findings suggest that biologic therapy may improve EP severity at week 4 and decrease the BSA at week 8.