[Successful treatment of generalized pustular psoriasis with certolizumab]

Generalized pustular psoriasis is a rare, often relapsing and usually severe inflammatory skin disease with concomitant systemic symptoms in many cases. The disease is in part due to mutations in the gene of the interleukin-36 receptor antagonist (IL36RN) explaining the autoinflammatory nature of this condition. Here, we report on a 39-year-old pregnant woman who stopped her medication with secukinumab due to her pregnancy. Subsequently, she suffered from severe exacerbation of her disease and was admitted to our hospital. The patient had a known mutation in the IL36RN (Ser113Leu) gene. At the 33rd week of her pregnancy therapy with certolizumab was initiated and resulted in a rapid remission within a few weeks. After the patient gave birth, remission could be maintained under the given therapy with this biologic.