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Li Yonghe

Air Force Characteristic Medical Center

Dermatology

Attending physician

Basic information

General information: The patient is a 28-year-old male.

chief complaint: repeated erythema, papules and scales all over the body for 13 years.

Current medical history: The patient suffered from sore throat in the summer of 26, with several bright red erythema and papules on his back the size of a fingernail, with clear boundary, covered with thick silvery white scales and mild itching. He was diagnosed as "psoriasis" by skin histopathological examination in a local hospital. During this period, similar skin lesions gradually spread to scalp, trunk and limbs. He took Chinese medicine decoction (the details are unknown) and "Compound Aminopeptide Tablets, Danqing Capsules and Compound Glycyrrhizin Tablets" orally, and used "Compound Coal Removal Liquid, Hasinide Solution, Mometasone Furate Cream and Carbotriol Ointment" externally, which caused great skin lesions during treatment. The illness is mild and severe, and there is no obvious seasonality. The inducing or aggravating factors are related to trauma, upper respiratory tract infection, smoking, staying up late, mental anxiety and spicy and irritating diet.

specialist physical examination: scalp, neck, trunk and limbs are covered with large patches of infiltrating dark red spots, which are covered with a thin layer of silvery white scales, with Auschwitz sign (+). The lesions are mainly on the extended side of the back and limbs, and the area of the lesions is about 6% of the body surface area. Bundle hair can be seen, and the nails on both sides are slightly turbid and thickened, with thimble-like changes on the surface. No blisters or pustules are found in the whole body, and there is no swelling, pain and deformity in the joints of the whole body.

Past history: fatty liver, multiple polyps in gallbladder, nothing special.

personal history: smoking for 1 years, with an average of 15 cigarettes per day, and no drinking history.

family history: nothing special.

After treatment,

"Plaque psoriasis" was diagnosed according to the medical history and typical clinical manifestations. After the infection and tumor were ruled out, skouchizumab was injected subcutaneously. The treatment plan was: subcutaneous injection of 3mg each time, once a week in the /1/2/3/4 week, then once a month, and 8 times in April. After the fourth injection (at the end of the first month), the lesions of the head, neck, trunk and upper limbs basically subsided, leaving behind post-inflammatory pigmentation, and the original flaky infiltrating plaques of lower limbs were obviously flattened and subsided. At the eighth injection (the fourth month of treatment), the skin lesions completely subsided, and the pigmentation after inflammation of the head, neck and trunk was less than before, leaving the pigmentation after inflammation in both lower limbs, and there was no new rash all over the body. There was no obvious discomfort and upper respiratory tract infection during the treatment.

figure 1 before treatment

figure 2 after the fourth injection

figure 3 after the eighth injection

conclusion

skukiyuzumab is a monoclonal antibody of IL-17A, which is mainly suitable for the treatment of moderate and severe plaque psoriasis. This patient has extensive skin lesions and many inducing factors, which seriously affects the quality of life and physical and mental health. Although the conventional treatment can achieve a certain effect, it still has mild recurrence under the inducing factors, and the mode and frequency of medication make it difficult for patients to insist on treatment. After using skukiyuzumab, the patient did not strictly avoid the inducing factors, and his condition was always stable and there was no recurrence. The mode of administration is simple and easy to operate, with good patient compliance and high satisfaction.

To sum up, Scochizumab injection has the advantages of high efficiency, rapidity and safety, and it is the preferred treatment for psoriasis patients.

click to view the concise prescription information of scochizumab.