Abstract
Generalized pustular psoriasis (GPP) is a rare and severe variant of psoriasis, especially in pediatric patients, characterized by recurrent episodes of fever, malaise, and sterile pustules. We present the case of an eight-year-old girl with genetically confirmed GPP, carrying heterozygous mutations in IL36RN and CARD14, successfully treated with adalimumab in combination with methotrexate. Despite previous therapies, sustained remission was achieved only with this regimen. This case highlights the importance of genetic testing and the potential role of biologic agents in the management of pediatric GPP.