Generalized Pustular Psoriasis with Cushing’s Syndrome: A Case of Effective Spesolimab Treatment

Guoyao Peng,* Yun Zhang,* Shuang Zhang,* You Li, Liping Luo, Jiaxin Luo, Xinyi Nie, Hongwei Zhang, Chengcheng Liao Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chengcheng Liao, Yunnan University of Traditional Chinese Medicine, No. 1076, Yuhua Road, Chenggong District, Kunming, Yunnan Province, People’s Republic of China, Email [email protected]: Generalized pustular psoriasis (GPP) is a rare neutrophilic skin disease characterized by persistent symptoms and sudden onset of painful, sterile pustules. These pustules may be accompanied by systemic inflammation and can be life-threatening in severe cases. Presently, there is an absence of standardized guidelines for treatment, and the majority of conventional treatments employed by clinicians are predicated on the utilization of glucocorticosteroids, immunosuppressants, and retinoids to attain anti-inflammatory and immune-suppressing effects. However, the therapeutic effect is often unsatisfactory and patients are prone to side effects. The IL-36 receptor monoclonal antibody, Spesolimab, signifies a novel therapeutic modality that has received approval from both the National Drug Administration (NMPA) of China and the US Food and Drug Administration (FDA) for the management of acute exacerbations of GPP. We report a case of a 40-year-old male patient diagnosed with GPP who had no significant improvement in symptoms and development of Cushing’s syndrome after up to six months of treatment with glucocorticoids, immunosuppressants, and retinoids. The patient was treated with Spesolimab, a monoclonal antibody, resulting in a substantial improvement in symptoms. This development offers novel treatment options and provides a reference for clinical medication for patients with this particular type of GPP.Keywords: generalized pustular psoriasis, spesolimab, biologic agents, case report