Targeting IL-17A for the treatment of pustular psoriasis: a comprehensive review

Introduction: Pustular psoriasis (PP) is a rare subtype of psoriasis. Overall, the growing evidence–in particular for acute generalized PP (GPP)–supports that it is a separate entity with a specific pathogenetic pathway. Interleukin (IL)-17/T-helper 17 (Th17) axis involvement may play an important role in the pathophysiology of PP. Biologicals, often required to achieve clinical remission, have changed the treatment of PP. Areas covered: We provide the reader with an overview of all the available evidence on the use of the antibody-based therapy targeting IL-17A in patients with PP. Expert opinion: Although papers reported in this review do not provide definitive evidence (due to methodological limitations) to support the use of IL-17 inhibitors as potential first-line for the treatment of PP, based on our own experience and according to most of the reported literature, targeting IL-17A, may represent the best therapeutical approach in this peculiar clinical spectrum of psoriasis.