Juvenile Generalized Pustular Psoriasis: Management in Children-A Case Series.

Area of Science:

• Dermatology
• Pediatrics
• Immunology

Background:

• Juvenile Generalized Pustular Psoriasis (GPP) is an extremely rare, life-threatening inflammatory disease.
• Pediatric GPP lacks established management guidelines.
• Cases presented with erythema, sterile pustules, fever, and malaise, without prior plaque psoriasis history.

Purpose of the Study:

• To report three cases of Juvenile GPP.
• To evaluate treatment strategies for pediatric GPP.
• To highlight the role of Cyclosporine and Acitretin in resource-limited settings.

Main Methods:

• Case series reporting three pediatric patients with GPP.
• Treatment involved Cyclosporine (low dose initially, escalated as needed).
• Acitretin was used as maintenance therapy (25mg alternate days due to capsule availability).

Main Results:

• One patient responded to low-dose Cyclosporine alone.
• Two patients required escalated Cyclosporine doses (≥5mg/kg) due to relapses.
• Acitretin maintenance therapy led to significant improvement and reduced relapse frequency.

Conclusions:

• Cyclosporine and Acitretin are viable therapeutic options for Juvenile GPP.
• These agents are crucial in resource-limited settings where biologics are inaccessible.
• Effective management of pediatric GPP can be achieved with careful titration of these agents.