Case Report: Successful treatment of generalized pustular psoriasis with concomitant renal insufficiency using spesolimab: a report of two cases.

Authors

You Xie, Feng Cheng, Zilu Qu, Lei Hu, Yun Xia, Liuqing Chen, Jinbo Chen

Published in

Frontiers in immunology. Volume 17. Pages 1880139. Epub Oct 05, 2026.

Abstract

Generalized pustular psoriasis (GPP) is a rare, severe, and potentially life-threatening neutrophilic dermatosis. Management focuses on rapid control of acute flares and prevention of recurrence. Advances in understanding the central role of interleukin-36 (IL-36) signaling in GPP pathogenesis have shifted the treatment paradigm from traditional systemic immunosuppressants toward targeted biologic therapies. This case report details two patients with GPP and comorbid renal insufficiency who achieved rapid and significant clinical improvement with spesolimab, an IL-36 receptor antagonist. Both patients presented with acute GPP flares and moderate renal impairment. Following a single 900 mg intravenous infusion of spesolimab, skin lesions and systemic symptoms resolved promptly, with disease stability maintained during follow-up. This report provides preliminary evidence supporting the efficacy and safety of spesolimab in this special patient population.

PMID:
42898567
Bibliographic data and abstract were imported from PubMed on 20 Oct 2026.

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