A case of psoriasis successfully treated by extracorporeal photopheresis during COVID-19 pandemic

Transfus Apher Sci. 2021 Oct;60(5):103200. doi: 10.1016/j.transci.2021.103200. Epub 2021 Jun 26.

Abstract

Psoriasis is a chronic inflammatory skin disease that is characterized by well-demarcated erythematous plaques with a silver scale. Although many new and emerging therapeutic agents are often sufficient to control the disease, there is still a need for alternative treatment options in challenging cases. Extracorporeal photopheresis (ECP) has been applied to many T-cell-mediated diseases to restore immune homeostasis and treat psoriasis effectively. In this paper, we present a psoriasis patient who did not respond to methotrexate, narrowband ultraviolet B, or acitretin. Because of a diagnosis of non-Hodgkin lymphoma, the patient had contraindications for cyclosporine, fumaric acid esters, and biologics but achieved remission with a total of 12 sessions of ECP in two and a half months. Although exacerbation was recorded after polymerase chain reaction (PCR) confirmed coronavirus 2019 (COVID-19) disease infection at the end of the first month, scores from the psoriasis area severity index (PASI) and dermatological life quality index (DLQI) were regressed significantly within two and a half months. ECP seems to provide an effective and rapid response for psoriasis and should be considered for psoriasis patients who fail to respond or have contraindications to existing treatments.

Keywords: Comorbidity; Extracorporeal photopheresis; Management; Psoriasis; Treatment.

Publication types

  • Case Reports

MeSH terms

  • Acitretin / therapeutic use
  • COVID-19 / complications*
  • Chemical and Drug Induced Liver Injury / etiology
  • Combined Modality Therapy
  • Contraindications, Drug
  • Cyclosporine / adverse effects
  • Humans
  • Lymphoma, Non-Hodgkin / complications*
  • Male
  • Methotrexate / adverse effects
  • Methotrexate / therapeutic use
  • Middle Aged
  • Nails / pathology
  • Pandemics*
  • Photopheresis*
  • Psoriasis / complications
  • Psoriasis / drug therapy*
  • Psoriasis / pathology
  • Psoriasis / radiotherapy
  • Quality of Life
  • SARS-CoV-2*
  • Severity of Illness Index
  • Ultraviolet Therapy

Substances

  • Cyclosporine
  • Acitretin
  • Methotrexate