Abstract: We report two patients with acute generalized pustular psoriasis (GPP) treated with spesolimab of a single 900 mg intravenous dose. Both patients were male and had a history of psoriasis vulgaris. The pretreatment generalized pustular psoriasis physician's general assessment (GPPGA) score was 4 in both patients. The scores of generalized pustular psoriasis area and severity index (GPPASI) were 48.0 and 59.3, respectively. The GPPGA pustular score of both were 0 at 48 hours after treatment, and the improvement rates of GPPASI were 91.04% and 89.21%, respectively. Laboratory parameters including white blood cell count, neutrophil count, neutrophil ratio, and C-reactive protein returned to or near normal levels within 48 hours after the application of spesolimab, and there was no recurrence during the 1-week observation. Body temperature returned to normal within 24 hours after the administration of spesolimab without recurrence.

Key words: acute generalized pustular psoriasis, spesolimab