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Abstract

Generalized pustular psoriasis (GPP) is a rare dermatosis which can cause devastating consequences for both the mother and the fetus. There is a high risk of intrauterine growth restriction, and even miscarriage and still birth. Maternal sepsis is a known complication of GPP. Aggressive treatment and careful monitoring of both mother and fetus are vital in the management. Diagnosis is primarily clinical, confirmed by laboratory investigations and typical findings of histopathology. Treatment is difficult for the possible risk of teratogenicity of most of drugs used in its treatment. Biological agents are recently being used successfully. For severe forms of psoriasis during pregnancy, monoclonal antibodies that target deregulated cytokines, such as ustekinumab (IL-12/23 inhibitor) and secukinumab (IL-17 inhibitor),1 can be beneficial. There is a risk of recurrence in subsequent pregnancies which presents earlier with more severe fetomaternal outcome. We report our experience of GPP in pregnancy on secukinumab.

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