Infantile pustular psoriasis: Case report of successful treatment with acitretin in a 4-week-old infant

Abstract

IPP: infantile pustular psoriasis INTRODUCTION Generalized pustular psoriasis is a severe variant of psoriasis characterized by scattered pustules on top of underlying erythematous skin, distributed across the trunk and extremities. Infantile pustular psoriasis (IPP) is extremely rare and thought to account for approximately 0.6% of pustular psoriasis cases. However, early diagnosis and management of infantile cases is critical to avoid life-threatening complications, such as bacterial super-infection and sepsis. Infantile pustular psoriasis presents a therapeutic challenge due its rarity, risk for adverse outcomes, and lack of evidence as to best practices for treatment. The scarcity of cases has resulted in a large portion of current clinical evidence being sourced from case reports and series, rather than large observational studies or randomized trials. Systemic retinoid treatment, particularly acitretin, has been proposed and shown efficacious as a first-line treatment for pustular psoriasis. Here, we report a case of a 4-week-old infant with IPP who was successfully treated using acitretin. To our knowledge, this is the youngest patient with IPP in the extant literature to respond successfully to systemic retinoid treatment.