Rapid Clearance of Erythrodermic Psoriasis with Acitretin in an Unstable Case of Psoriasis under Treatment with Secukinumab

EP may occur in association with life-threatening complications such as superinfections and sepsis from skin pathogens such as Staphylococcus aureus and Streptococcus species, hypovolemic shock and acute kidney injury secondary to skin fl uid loss, severe anemia, acute respiratory distress syndrome, hydroelectrolytic abnormalities and protein loss [2,3,5,8].Th e management of this condition is based on the use of anti-infl ammatory, immunosuppressive and biologic agents following the supportive care [3].Acitretin is a second-generation retinoid used in the treatment of severe resistant psoriasis.Experts support the use of acitretin as a fi rst-line therapy in stable cases of erythrodermic psoriasis, although it typically works slowly [4].We report a case of complete and rapid resolution of EP with acitretin, demonstrating its effi cacy for controlling the occurrence of erythrodermic fl ares, in a patient with moderate-to-severe plaque psoriasis eff ectively treated with secukinumab until then (PASI 100). Case reportA 34-year-old man with generalized erythema and extensive scaling presented to our dermatology department.Th e patient had a 20-year history of moderate-to-severe plaque psoriasis vulgaris (baseline PASI score 29.0), without concomitant arthritis, and was successfully treated with secukinumab in the last year (PASI score 0).He did not have any other new drug exposures and did not use topical medications other than moisturizers, in the last 3 months