Methotrexate and Adalimumab Combination Efficacy in 4-year-old Child with Generalized Pustular Psoriasis: Case Study

Background. Generalized pustular psoriasis management in children is a topical issue due to limited use and efficacy of traditional immunodepressants, absence of registered genetically engineered biologic drugs. The description of biological drugs treatment results in children with pustular psoriasis within off-label indications is still relevant. Case description . 4-year-old child with generalized pustular psoriasis had limited methotrexate efficacy (cutaneous lesions exacerbations at a dose of 7.5 mg subcutaneously once per week), thus, genetically engineered biologic drug adalimumab was prescribed at a dose of 20 mg subcutaneously according to the recommended regimen. Positive dynamics was noted at follow-up scheduled examinations: complete regression of pustular rashes, laboratory blood values normalization, achievement of the PASI 100 at week 17. No side effects of adalimumab therapy were noted. Conclusion. Treatment with adalimumab (according to the recommended regimen) may be suggested in patients with generalized pustular psoriasis due to pathological process course severity, inefficacy of standard external therapy, antihistamine therapy, physiotherapy, traditional immunodepressants, including insufficient response to methotrexate, and in cases with no contraindications.