Juvenile generalized pustular psoriasis treated with etanercept

An 8‐year‐old boy with general pustular psoriasis (GPP) and iatrogenic secondary Cushing syndrome was treated successfully with etanercept after he had failed on acitretin, methotrexate, and methylprednisolone therapy. GPP is a severe and very rare variant of psoriasis in children often accompanied by life‐threatening complications. Retinoids, cyclosporine, methotrexate, or dapsone used in a small number of case series and case reports were effective. Etanercept is a recombinant human tumor necrosis factor‐alpha (TNF‐alpha) receptor protein fused with Fc portion of IgG1 that binds to TNF‐alpha, approved by Food and Drug Administration for the treatment of moderate‐to‐severe plaque psoriasis in children and teens who have not responded to other psoriasis treatments. In our patient, etanercept demonstrated significant clinical response associated with long‐term efficacy without acute exacerbation, excellent tolerability, and good safety profile.