Erythrodermic
psoriasis (EP) is a very severe variant of
psoriasis whose management poses a challenge to physicians, as currently available
therapies often provide unsatisfactory results. Many biologics have been used to treat chronic plaque
psoriasis, the most common form of
psoriasis; however, their effectiveness for EP is poorly understood. A recently developed
biologic,
golimumab, has been extensively studied for the treatment of moderate-to-severe active
rheumatoid arthritis,
psoriatic arthritis, active
ankylosing spondylitis, and chronic plaque
psoriasis. However, no clinical trials have been performed for EP. Here, we report the case of a 32-year-old man who presented with severe
psoriasis that previously failed to respond satisfactorily to
methotrexate,
cyclosporine,
retinoid, narrow-band ultraviolet B
phototherapy, and topical agents (i.e.,
steroids and
calcipotriol). Skin lesions worsened progressively and developed into
erythroderma.
Psoriatic arthritis was also detected. Conventional
therapies lacked efficacy. Therefore, we administered
golimumab 50 mg. The skin lesions improved significantly according to the
Psoriasis Area and Severity Index score after the first administration; lesions improved further throughout the treatment course. Although additional studies are required to fully evaluate the efficacy and safety of
golimumab, this agent may be an alternative treatment strategy for some patients with recalcitrant EP.