Early Temporal Dissociation Between C-Reactive Protein and Neutrophil Counts After Spesolimab Treatment in Generalized Pustular Psoriasis

Generalized pustular psoriasis (GPP) is a rare and severe inflammatory disease characterized by widespread sterile pustules and systemic manifestations.In addition to cutaneous symptoms, GPP is associated with systemic inflammation, as reflected by fever, elevated white blood cell (WBC) and neutrophil counts, increased serum C-reactive protein (CRP) level and decreased serum albumin level.Since GPP can be life-threatening, rapid control of systemic inflammation is essential.Spesolimab, a monoclonal antibody targeting the interleukin (IL)-36 receptor, has demonstrated efficacy in GPP flares (1), and our previous realworld study showed rapid clinical improvement, particularly in pustular lesions (2).However, day-to-day changes in systemic inflammatory markers after spesolimab treatment remain unclear.Therefore, we aimed to evaluate the early effects of spesolimab on systemic inflammatory markers during the first 14 days of treatment in patients with GPP.