What treatment options would you recommend for a patient with severe generalized pustular psoriasis who has a history of colon cancer (s/p chemotherapy) and well-controlled HIV?

Currently on 6 mg dexamethasone daily post-hospitalization. Insurance is denying acitretin. Would an IL-23 inhibitor like Skyrizi be appropriate? Otezla has been initiated but has shown limited effectiveness.

Answer from: at Academic Institution

I'd feel comfortable doing an IL17 or IL23. Bimekizumab would be my first choice with it's higher efficacy with almost all types of psoriasis. There's also a small dataset showing it worked quite well for GPP in a subset of japanese patients. IL36 is my favorite drug for GPP but I'm not aware...

Comments

at University of California San Francisco Medical School
Is there any reason not to use the IL-36 blocker S...

at UCLA Health
There's no absolute contraindications to spesolima...

at Dept Dermatology Jefferson Medical College
Acitretin is always an option as well.

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What treatment options would you recommend for a patient with severe generalized pustular psoriasis who has a history of colon cancer (s/p chemotherapy) and well-controlled HIV?

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