Case Report: Successful treatment of refractory generalized pustular psoriasis with xeligekimab: a report of two cases

Generalized pustular psoriasis (GPP) is a severe, relapsing skin disorder characterized by widespread erythema and sterile pustules. Classical systemic therapies often yield suboptimal results. Xeligekimab is a novel, fully human anti-interleukin-17A (anti-IL-17A) monoclonal antibody recently approved in China for plaque psoriasis. Its efficacy in GPP has not been previously reported. This report presents two cases of refractory GPP successfully treated with xeligekimab. Both patients- a 25-year-old male and a 70-year-old male had long-standing GPP that was unresponsive to conventional systemic therapies including acitretin and methotrexate. After receiving a single 200 mg dose of xeligekimab, both patients exhibited rapid and significant clinical improvement within 3 to 4 days. Remarkably, one patient remained in remission at the 3-month follow-up after only one injection. This is the first report to suggest that xeligekimab is a potent and promising therapeutic option for inducing rapid and sustained remission in patients with GPP.