Secukinumab in the Treatment of Generalized Pustular Psoriasis

Abstract

Generalized pustular psoriasis is a rare but severe chronic inflammatory skin disorder characterized by sudden eruptions of sterile pustules, often accompanied by systemic inflammation. Secukinumab, a human monoclonal antibody targeting interleukin-17A, interrupts downstream inflammatory signaling in psoriasis. Although secukinumab is neither a first-line therapy nor officially approved for generalized pustular psoriasis treatment in our country, it has shown promising clinical results. we present the case of a 34-year-old woman with a longstanding history of disseminated plaque psoriasis intermittently complicated by generalized pustular and erythrodermic flares. She was admitted to our Department with fever and malaise, and examination revealed widespread erythematous, scaly plaques with numerous pustules distributed over the trunk and extremities. Secukinumab was initiated at 300 mg weekly for five weeks, followed by monthly maintenance dosing. The patient achieved rapid clinical improvement and has remained stable remission for six years under continuous interleukin 17A antagonist therapy, demonstrating both the efficacy and durability of this therapeutic approach.