Case report: Successful treatment of acute generalized pustular psoriasis with multiple comorbidities with oral tacrolimus

Front Immunol. 2024 Mar 19:15:1354578. doi: 10.3389/fimmu.2024.1354578. eCollection 2024.

Abstract

Acute generalized pustular psoriasis (GPP) is a serious illness. Despite various treatment methods, there is still lack of effective treatment plans for refractory cases with multiple comorbidities. This case report presents a 67-year-old woman with acute GPP, stage 4 chronic kidney disease (CKD), type 2 diabetes, and cardiovascular disease, in whom skin symptom disappearance and kidney function improvement were observed after the use of oral tacrolimus as the sole therapy. This is the first report on the application of tacrolimus in the treatment of acute GPP, especially refractory acute GPP. The successful treatment indicates that there are shared immune pathways between acute GPP and CKD, and the pathways can be interdicted by tacrolimus. Further studies are needed to optimize the therapy to maximize efficacy and minimize toxicity.

Keywords: acute generalized pustular psoriasis; case report; oral; tacrolimus; treatment.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Chronic Disease
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Female
  • Humans
  • Interleukins
  • Psoriasis* / complications
  • Psoriasis* / diagnosis
  • Psoriasis* / drug therapy
  • Renal Insufficiency, Chronic* / complications
  • Tacrolimus / therapeutic use

Substances

  • Tacrolimus
  • Interleukins

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by grants from the Chongqing Talent Plan Project of Chongqing Municipal Health Commission (Grant NO.CQYC20200303138) and the Top Young Talent of Chongqing Hospital of Traditional Chinese Medicine.