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Efalizumab-associated papular psoriasis.

Akmal S Hassan1, Dagmar Simon, Hans-Uwe Simon

  • 1Department of Dermatology, University of Bern, Inselspital, 3010 Bern, Switzerland.

Archives of Dermatology
|July 20, 2007
PubMed
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Efalizumab-associated papular psoriasis (EAPP) presents as new psoriatic lesions during treatment. These papular eruptions typically do not require stopping efalizumab and can be managed with topical corticosteroids.

Area of Science:

  • Immunodermatology
  • Dermatopathology

Background:

  • Efalizumab, a human anti-CD11a monoclonal antibody, treats moderate to severe plaque psoriasis.
  • Some patients develop new papular lesions, often in flexural areas, during efalizumab therapy.

Observation:

  • Four patients with recalcitrant psoriasis developed papules and small plaques after 4-10 weeks of efalizumab.
  • Histopathology revealed psoriatic features and activated leukocytes, including T cells, dendritic cells, macrophages, and neutrophils.

Findings:

  • Papular eruptions during efalizumab therapy are new psoriatic lesions, termed efalizumab-associated papular psoriasis (EAPP).
  • These lesions indicate an immune response involving various leukocyte subtypes.

Implications:

Related Experiment Videos

  • EAPP generally does not necessitate discontinuing efalizumab treatment.
  • Topical corticosteroids can be an effective optional treatment for EAPP.
  • Dermatologists should recognize EAPP and counsel patients on its management.