Etanercept combined with methotrexate for the treatment of a pediatric case with erythrodermic psoriasis and nail involvement; and review of the literature

Abstract

Psoriasis is a chronic, inflammatory skin disease. The incidence is not known in pediatric age. About one-third of psoriasis vulgaris patients have been estimated to be pediatric cases. Erytrodermic psoriasis is rare in this group. We present here a pediatric case with erythrodermic psoriasis and nail involvement recalcitrant to conventional therapies, improved by etanercept therapy. Our case is a 17-year old female patient and was first diagnosed with psoriasis at 6 years old. She has been erythrodermic since 9 years old. She had used only topical corticosteroids. Considering the ineffectivity of conventional treatments, etanercept therapy was initiated and has been continued with methotrexate for 14 months. Etanercept is a TNF-alpha inhibitor that has become popular as a specific target therapy recently. It seems to be a well-tolerated, effective treatment option with a good safety profile for pediatric psoriasis cases who can not use conventional treatments because of their systemic side effects. Copyright © 2012 by Türkiye Klinikleri.