We report a case of a 7-year-old male patient with
vaccine-induced erythrodermic
psoriasis (EP) complicated by pulmonary
infection,
hypoproteinemia, and
liver dysfunction successfully treated with
secukinumab in combination with symptomatic and supportive
therapy. The patient presented with diffuse
flushing on the head, face, trunk, and limbs, which were covered with chaff-like white scales in the
rash-affected area, with no
blisters, pustules, and no apparent abnormalities in the palms, soles, nails, and joints. Histopathology analysis revealed hyperkeratosis, focal
parakeratosis, thinning or effacement of the granular layer, psoriasiform
hyperplasia of the epidermis, neutrophilic microabscess formation in the upper part of the epidermis,
edema of the dermal papilla, dilation of blood vessels, and lymphocyte infiltration. The patient was eventually diagnosed with EP. At weeks 0, 1, and 2, the patient received a
subcutaneous injection of 150 mg
secukinumab (three
injections).
Fluticasone propionate ointment, taccathitol
ointment, yellow
vaseline, and other drugs were also given topically. Following 2 weeks of treatment, the child's skin lesions resolved significantly with only slight pigmentation remaining and the
Psoriasis Area and Severity Index (PASI) score decreased from 37.5 to 7.5 (PASI 75). Thereafter, 150 mg
secukinumab was injected every 4 weeks until the last dose at 18 weeks (four more
injections). After 18 weeks, the child's lesion resolved entirely (PASI 100), and no adverse effects were reported.