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Successful use of acitretin in conjunction with narrowband ultraviolet B phototherapy in a child with severe pustular psoriasis, von Zumbusch type.
Br J Dermatol. 2004 Oct; 151(4):912-6.BJ

Abstract

Severe pustular psoriasis von Zumbusch type is a therapeutic challenge not only in adults, but even more in children. We report a 3(1/2)-year-old boy who developed a generalized flare of diffusely scattered pustules on erythematous skin which rapidly progressed to large exuding areas. The clinical presentation and investigations including histopathological examination of a biopsy and negative bacterial cultures were consistent with the diagnosis of pustular psoriasis von Zumbusch type. Upon initial treatment with methylprednisolone, acitretin and antibiotics the extent of the disease declined. However, several attempts to reduce the dose of the oral corticosteroid were followed by immediate severe flares. Additional treatment with narrowband ultraviolet B (NB-UVB, 311-313 nm UVB) resulted in a rapid arrest of disease activity and allowed the corticosteroid to be tapered off. After 10 irradiations the patient was both off steroid and disease free. NB-UVB therapy was subsequently reduced to twice-weekly exposures and acitretin gradually diminished to a maintenance dose of 0.3 mg kg(-1) daily. We conclude that NB-UVB in conjunction with acitretin is a potent therapeutic regimen for the treatment of severe pustular psoriasis von Zumbusch type in childhood.

Authors+Show Affiliations

Kopp T
Department of Paediatrics, Division of General Paediatrics, Vienna Medical University, Währinger Gürtel 18-20, A-1090 Vienna, Austria. tamara.kopp@akh-wien.ac.at
Karlhofer F
No affiliation info available
Szépfalusi Z
No affiliation info available
Schneeberger A
No affiliation info available
Stingl G
No affiliation info available
Tanew A
No affiliation info available

MeSH

AcitretinChild, PreschoolCombined Modality TherapyHumansKeratolytic AgentsMalePsoriasisUltraviolet Therapy

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15491438

Citation

Kopp, T, et al. "Successful Use of Acitretin in Conjunction With Narrowband Ultraviolet B Phototherapy in a Child With Severe Pustular Psoriasis, Von Zumbusch Type." The British Journal of Dermatology, vol. 151, no. 4, 2004, pp. 912-6.
Kopp T, Karlhofer F, Szépfalusi Z, et al. Successful use of acitretin in conjunction with narrowband ultraviolet B phototherapy in a child with severe pustular psoriasis, von Zumbusch type. Br J Dermatol. 2004;151(4):912-6.
Kopp, T., Karlhofer, F., Szépfalusi, Z., Schneeberger, A., Stingl, G., & Tanew, A. (2004). Successful use of acitretin in conjunction with narrowband ultraviolet B phototherapy in a child with severe pustular psoriasis, von Zumbusch type. The British Journal of Dermatology, 151(4), 912-6.
Kopp T, et al. Successful Use of Acitretin in Conjunction With Narrowband Ultraviolet B Phototherapy in a Child With Severe Pustular Psoriasis, Von Zumbusch Type. Br J Dermatol. 2004;151(4):912-6. PubMed PMID: 15491438.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful use of acitretin in conjunction with narrowband ultraviolet B phototherapy in a child with severe pustular psoriasis, von Zumbusch type. AU - Kopp,T, AU - Karlhofer,F, AU - Szépfalusi,Z, AU - Schneeberger,A, AU - Stingl,G, AU - Tanew,A, PY - 2004/10/20/pubmed PY - 2005/2/8/medline PY - 2004/10/20/entrez SP - 912 EP - 6 JF - The British journal of dermatology JO - Br J Dermatol VL - 151 IS - 4 N2 - Severe pustular psoriasis von Zumbusch type is a therapeutic challenge not only in adults, but even more in children. We report a 3(1/2)-year-old boy who developed a generalized flare of diffusely scattered pustules on erythematous skin which rapidly progressed to large exuding areas. The clinical presentation and investigations including histopathological examination of a biopsy and negative bacterial cultures were consistent with the diagnosis of pustular psoriasis von Zumbusch type. Upon initial treatment with methylprednisolone, acitretin and antibiotics the extent of the disease declined. However, several attempts to reduce the dose of the oral corticosteroid were followed by immediate severe flares. Additional treatment with narrowband ultraviolet B (NB-UVB, 311-313 nm UVB) resulted in a rapid arrest of disease activity and allowed the corticosteroid to be tapered off. After 10 irradiations the patient was both off steroid and disease free. NB-UVB therapy was subsequently reduced to twice-weekly exposures and acitretin gradually diminished to a maintenance dose of 0.3 mg kg(-1) daily. We conclude that NB-UVB in conjunction with acitretin is a potent therapeutic regimen for the treatment of severe pustular psoriasis von Zumbusch type in childhood. SN - 0007-0963 UR - https://www.unboundmedicine.com/medline/citation/15491438/Successful_use_of_acitretin_in_conjunction_with_narrowband_ultraviolet_B_phototherapy_in_a_child_with_severe_pustular_psoriasis_von_Zumbusch_type_ DB - PRIME DP - Unbound Medicine ER -