Psoriasis of special localizations. Experience with the use of the interleukin-17A inhibitor netakimab for the treatment of psoriasis of special localizations

Psoriasis is a chronic immune-mediated inflammatory disease characterized by widespread characteristic lesions of the skin, nail plates and the development of comorbid pathologies (psoriatic arthritis, metabolic syndrome, cardiovascular diseases, etc.), which affects up to 11% of the world’s population. Psoriasis of the scalp, nails, palmoplantar area and genitals, which is often considered “difficult to treat”, is associated with a significant decrease in health-related quality of life (HRQoL) and may be a predictor for the development of psoriatic arthritis. Involvement of specific areas in patients with psoriasis may occur in up to 80–90% of cases at least once during life. The prevalence of involvement of these areas on average is: scalp – 45–56%, genitals – 30–40%, nail psoriasis – in 23–27% of cases, rashes on the face – 49%, palms and soles – 12–16% and intertriginous areas – 21–30%. The quality of life of patients with psoriasis of «difficult localizations» can be disproportionately affected, for example, due to the presence of lesions in visible areas, the patient’s self-esteem may be reduced, or involvement of the palms may lead to limitations in daily activities. Patients most often report feelings of shame, embarrassment and stigmatization. The goal of psoriasis treatment is supposed to be a reduction in the affected body surface area, stable remission and maintenance of «clear skin», which leads to a significant improvement in the patients’ health-related quality of life and their ability to work. Guidelines for the treatment of psoriasis in special localizations recommend considering systemic therapy, especially if topical therapy has proven ineffective. This article presents the results of successful treatment of patients with psoriasis of special localizations with the biologic drug IL-17A inhibitor netakimab.