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Updated: Feb 28, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Severe paradoxical generalized pustular psoriasis induced by adalimumab biosimilar successfully treated with
Angela Fico1, Edoardo Mortato1, Claudia Paganini1
1Department of Systems Medicine, University of Rome "Tor Vergata".
Abstract:
Paradoxical psoriasis is a rare but increasingly recognized adverse effect of anti-tumor necrosis factor-α (TNF-α) therapy, characterized by the onset or exacerbation of psoriatic lesions in patients treated for other immune-mediated conditions. We report the case of a 47-year-old woman with chronic plaque psoriasis who developed severe generalized pustular psoriasis (GPP) after six months of treatment with an adalimumab biosimilar. Given the extent and severity of the eruption and following inadequate response to previous conventional therapies, the patient was treated with brodalumab, an interleukin-17 receptor A (IL-17RA) inhibitor. Rapid and complete remission of both pustular and plaque psoriasis was achieved and maintained for over 60 weeks. This case supports the efficacy of IL-17 pathway blockade in managing paradoxical GPP and highlights the importance of prompt recognition and appropriate therapeutic switching in severe biologic-induced psoriasis.
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