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Updated: Jun 2, 2026
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Stress-induced rupioid psoriasis managed with ustekinumab.
Gustavo Almeida-Silva1,2, Joana Antunes1,2
1Dermatology Department, Unidade Local de Saúde Santa Maria, Lisbon, Portugal.
Skin Health and Disease
|June 1, 2026
Summary
Acute stress can trigger rupioid psoriasis, a severe skin condition. Ustekinumab treatment showed significant improvement, suggesting interleukin (IL)-12/IL-23 blockade is effective for this psoriasis variant.
Area of Science:
- Dermatology
- Immunology
Background:
- Rupioid psoriasis is a rare, hyperkeratotic variant of psoriasis.
- Triggers for psoriasis variants are not fully understood.
- Acute stress is a potential, yet under-recognized, trigger for psoriasis exacerbations.
Purpose of the Study:
- To report the first case of stress-induced rupioid psoriasis.
- To evaluate the efficacy of ustekinumab in treating this rare phenotype.
- To emphasize the role of stress in hyperkeratotic psoriasis.
Main Methods:
- Case report of a patient with rupioid psoriasis.
- Assessment of disease presentation following acute psychological stress.
- Treatment with ustekinumab (an interleukin (IL)-12/IL-23 inhibitor).
Main Results:
- The patient presented with rupioid psoriasis after the loss of a close relative.
- Ustekinumab treatment resulted in significant clinical clearance of the lesions.
- The patient tolerated ustekinumab well, with no reported adverse events.
Conclusions:
- Acute stress can precipitate severe hyperkeratotic psoriasis, such as the rupioid variant.
- Interleukin (IL)-12/IL-23 blockade with ustekinumab appears effective for stress-induced rupioid psoriasis.
- Further research is needed to elucidate the pathophysiology and optimize treatment for hyperkeratotic psoriasis variants.
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