Abstract
RATIONALE: Generalized pustular psoriasis (GPP) is a severe form of pustular psoriasis, which can endanger the patient life. However, the conventional treatment for GPP presents several limitations. PATIENT CONCERNS: In this report, we present a 54-year-old male patient with GPP and chronic hepatitis B. The use of glucocorticoids and acitretin for GPP caused liver injury in our case. DIAGNOSES: The patient was diagnosed with GPP with chronic hepatitis B. INTERVENTIONS: The patient accepted traditional therapy, including glucocorticoids and acitretin. The use of glucocorticoids and acitretin for GPP caused liver injury in our case. Therefore, acitretin was discontinued (but not the glucocorticoid). After excluding contraindications, the patient was administered a single dose of spesolimab (900 mg). OUTCOMES: The rash resolved within 48 hours after the patient was administered a single dose of spesolimab (900 mg). LESSONS: Our study shows that spesolimab could be employed as a safe and effective therapeutic option for patients with GPP and other underlying conditions.