2013 Volume 123 Issue 9 Pages 1787-1796
We describe two cases of refractory psoriatic uveitis treated successfully with infliximab. Case 1: A 54-year-old man was diagnosed with erythrodermic psoriasis at the age of twenty-eight. He had suffered from severe and uncontrollable psoriatic skin lesions, and he developed uveitis in the right eye after ten years. He was orally treated with prednisolone (15 mg/day), but blindness resulted in the right eye due to intractable uveitis. He consulted our hospital for his continuous skin and eye disorders in 2011. His symptoms improved promptly after treatment with infliximab (5 mg/kg), although he presented with recurrence of the skin and eye symptoms before the seventh infliximab treatment. However, they are now being controlled well by an increased dose of infliximab (6.6 mg/kg). Case 2: A 34-year-old woman was diagnosed with psoriasis vulgaris at the age of nineteen. After delivering her first child in 2010, the skin rash suddenly disseminated over her trunk and extremities. She also suffered from severe arthritis in several joints and the arthritis responded poorly to the oral methotrexate treatment (6 mg/week). Moreover, ophthalmological examination revealed uveitis and optic neuritis in the right eye. Her symptoms improved promptly after applying infliximab (5 mg/kg) in addition to oral methotrexate treatment. Although in the skin, joint, and right eye symptoms exacerbated slightly before the fourth infliximab injection, they are now controlled well by increasing dose of infliximab (6.2 mg/kg) and methotrexate (8 mg/week). We also review five cases of psoriatic uveitis in our hospital, including the above mentioned cases, and discuss some risk factors for the development of psoriatic uveitis.
