PMC6628099_01
Case 1: psoriatic lesions on the legs and forehead (A) before and (B) after 14 months of brodalumab treatment.
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There were lesions on the trunk, arms, legs and especially the head (Figure 1A). By August 2018, after almost 1 year of treatment, the PASI score, DLQI score (Figure 2A) and BSA coverage were all zero, and these outcomes were maintained at the last follow-up (14 months after starting brodalumab; Figure 1B).
Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores before and after treatment with brodalumab. (A) Case 1, (B) Case 2, (C) Case 3, (D) Case 4.
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PMC6628099_02
Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores before and after treatment with brodalumab. (A) Case 1, (B) Case 2, (C) Case 3, (D) Case 4.
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Case 2: psoriatic lesions on the back of the lower legs and the right upper leg (A) before and (B) after 6 weeks on brodalumab, and on the back of the lower legs and right upper leg (C) after 32 weeks on brodalumab.
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At the time of the current investigation, the patient presented with mild scalp psoriasis and psoriatic arthritis (mainly arms and legs; Figure 3A), and a PASI score of 11.9. Psoriasis was markedly improved after 6 weeks (Figure 3B). By September 2018, the PASI score was reduced by over 90% to 0.8 (Figures 2B and 3C), BSA coverage was only 1%, and the DLQI score was zero (Figure 2B).
Case 3: psoriasis on the left elbow and nails (A) before and (B) after 16 weeks on brodalumab, and on the nails (C) after 32 weeks on brodalumab.
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On examination, the patient presented with mild plaques on the scalp, elbows, lower back and lower legs and severe nail involvement on both hands (Figure 4A) and feet. He had been diagnosed with psoriatic arthritis on his elbows (Figure 4A) and hips. After 16 weeks, his skin was free of plaques and elbow swelling was markedly reduced (Figure 4B); also, his previously severely-affected nails started to grow normally from the proximal end (Figure 4B), and the PASI score was 1. By 32 weeks, the patient's nails were completely normal again (Figure 4C), and he was very satisfied with the treatment outcome.
PMC6628099_03
Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores before and after treatment with brodalumab. (A) Case 1, (B) Case 2, (C) Case 3, (D) Case 4.
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Case 4: psoriatic lesions on (A) the back and (B) the soles of the feet before and after 5 weeks on brodalumab, and (C) on the hands before and after 20 weeks on brodalumab.
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B) and the PASI score had been reduced to 7.4. By week 20, the patient's skin condition had improved even further, and he no longer required any topical treatment (Figure 5C).