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Pharmacological Management of Pediatric Pustular Psoriasis

  • Therapy in Practice
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Abstract

Therapeutic management of pustular psoriasis remains a challenge despite the rapid advance in psoriasis research and the development of drugs, especially biologics. Treatment guidelines have been established for pustular psoriasis, but no controlled studies are present for juvenile pustular psoriasis (JPP). Search of the literature reveals that current evidence of JPP treatment is limited to case reports and case series. Among the conventional drugs for JPP, oral retinoid is the most commonly used, yet concerns for growth disturbance exist. Cyclosporine and methotrexate have also been administered as first-line treatment. Etanercept is the first biological agent approved for juvenile plaque psoriasis, followed by adalimumab. However, infliximab is usually recommended for JPP because of the rapidity of onset, despite not being approved for use in pediatric psoriasis patients. More recently, secukinumab, ixekizumab, brodalumab, guselkumab, and risankizumab have been approved for adult pustular psoriasis in selected countries. Controlled studies are needed to prove the efficacy and long-term safety of the therapeutic treatments currently used for JPP.

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  1. Department of Education, National Taiwan University Hospital, Taipei, Taiwan

    Yi-Wei Huang

  2. Department of Dermatology, National Taiwan University Hospital, No. 7 Chung San South Road, Taipei, Taiwan

    Tsen-Fang Tsai

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Dr. Yi-Wei Huang has no conflicts of interest to declare. Prof. Tsen-Fang Tsai has conducted clinical trials or received honoraria for serving as a consultant for AbbVie, Boehringer Ingelheim, Celgene, Eli-Lilly, Galderma, GSK, Janssen-Cilag, Leo Pharma, Merck-Serono, Novartis International AG, Pfizer Inc., and UCB Pharma.

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Huang, YW., Tsai, TF. Pharmacological Management of Pediatric Pustular Psoriasis. Pediatr Drugs 22, 265–277 (2020). https://doi.org/10.1007/s40272-020-00383-6

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