Authors:	Zimmer, Sebastian Goldust, Mohamad Bhargava, Shashank Wegner, Joanna Grabbe, Stephan Staubach-Renz, Petra
Title:	Combination therapy of recalcitrant severe psoriasis with psoriatic arthritis, diabetes nephropathy, and liver cirrhosis
Online publication date:	7-Sep-2022
Year of first publication:	2022
Language:	english
Abstract:	Objective: Treatment of recalcitrant moderate-to-severe psoriasis can be challenging. Combination therapy of biologics and immunosuppressive agents can be a new strat-egy for treating therapy- resistant cases with comorbidities, where many systemic medications are contraindicated.Case presentation: We report a case of a 62-year-old diabetic man with a 30-year history of severe plaque psoriasis and psoriatic arthritis with cirrhosis and diabetic nephropathy that was treated successfully in combination with apremilast and etaner-cept after multiple previous unsuccessful treatment attempts.Conclusion: There are no data supporting the combination of apremilast and etaner-cept in the management of recalcitrant cases of moderate-to-severe psoriasis and multiple comorbidities including psoriatic arthritis, diabetic nephropathy, and cirrho-sis. In patients who do not respond to multiple approaches for the treatment of pso-riasis, combination therapy with biologic agents and new systemic medications may lead to dramatic disease control.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-7697
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY-NC
Information on rights of use:	https://creativecommons.org/licenses/by-nc/4.0/
Journal:	Journal of cosmetic dermatology 21 5
Pages or article number:	2226 2228
Publisher:	Wiley-Blackwell
Publisher place:	Oxford
Issue date:	2022
ISSN:	1473-2165
Publisher DOI:	10.1111/jocd.14367
Appears in collections:	JGU-Publikationen