Psoriasis is a chronic inflammatory disease that affects around 1-3% of the adult population.The most common type, psoriasis vulgaris, is a consequence of genetic susceptibility and has multiple triggers. Immunological and genetic studies have identified cytokines such as TNF-α, IL-17 and IL-23 as key factors in the pathogenesis of psoriasis and became targets for the new biologic therapies. We present the case of a 65-year-old patient, smoker, who presents for an itchy rash consisting of erythematous plaques with thick, silvery scales afecting the palms and soles. Also, all fingernails and toenails presented pitting, onycholysis, subungual hyperkeratosis, oil drop discoloration and splinter hemorrhages, with an evolution of about one year. The nail changes were impressive, therefore the patient had functional impairment. The patient does not have arthralgias, a nonspecific feature for the significant nail involvement. At the time of the hospitalization, the patient had a form of severe psoriasis with a PASI score of 11.6, DLQI score of 27 and NAPSI score of 118. The blood tests were normal. Histopathological examination revealed highly suggestive changes to establish the diagnosis of psoriasis vulgaris. The patient followed numerous therapies with topical medication, PUVA therapy and methotrexate for 3 months, but without significant therapeutic success. Following highly modified scores, it was decided to initiate treatment with ixekizumab (Taltz), an anti-IL-17A monoclonal antibody. After 3 months, at a clinical evaluation, it was noticed an improvement of the palmoplantar and nail psoriatic lesions and an increase of the quality of life. Psoriasis vulgaris is a complex disorder of the skin and immune system, the purpose of the treatment being the remission of the lesions and prevention of the complications such as psoriatic arthritis by using a safe and effective therapy for the patient, initiated as soon as possible in the evolution of the disease.

ESDR015 - How important is the speed of response to biological therapy?

50th Annual Meeting of the European Society for Dermatological Research. VIRTUAL MEETING