Hiroshi Kawakami ¹, Yume Nagaoka ², Hirofumi Hirano ¹, Yuka Matsumoto ¹, Namiko Abe ¹, Ryoji Tsuboi ¹, Yoshihiko Kanno ², Yukari Okubo ¹ J Dermatol 2019 Feb;46(2):144-148.

We concluded that granulocyte and monocyte adsorption apheresis is a therapeutic option to consider when pustulotic arthro-osteitis is recalcitrant to conventional therapy.

https://pubmed.ncbi.nlm.nih.gov/30549087/

Asami Fujii ¹, Kento Fujii ¹, Mariko Seishima ¹ , Ther Apher Dial. 2019 Jun;23(3):298-299

https://pubmed.ncbi.nlm.nih.gov/31025533/

Hidenori Ohnishi ¹, Tomonori Kadowaki ¹, Yoko Mizutani ², Emi Nishida ³, Rie Tobita ⁴, Namiko Abe ⁴, Yukie Yamaguchi ⁵, Hikaru Eto ⁶, Masaru Honma ⁷, Takuro Kanekura ⁸, Yukari Okubo ⁴, Mariko Seishima ², Toshiyuki Fukao ¹, Shigaku Ikeda ⁹ , Eur J Dermatol. 2018 Feb 1;28(1):108-111.

https://pubmed.ncbi.nlm.nih.gov/29380726/

Asami Fujii ¹, Hidenori Ohnishi ², Mariko Seishima ¹ , Ther Apher Dial. 2018 Feb;22(1):92-93.

https://pubmed.ncbi.nlm.nih.gov/28913961/

Y Koike ¹, M Okubo ¹, T Kiyohara ¹, R Fukuchi ¹, Y Sato ¹, S Kuwatsuka ¹, T Takeichi ², M Akiyama ², K Sugiura ³, A Utani ¹ , Br J Dermatol. 2017 Dec;177(6):1732-1736.

Granulocyte monocyte apheresis, a process associated with few adverse events, promptly controlled the GPP of our paediatric patient, and has potential as a suitable alternative treatment for paediatric patients with DITRA.

https://pubmed.ncbi.nlm.nih.gov/28369922/

Chiharu Tominaga ¹, Masaaki Yamamoto ¹, Yasutomo Imai ¹, Kiyofumi Yamanishi ¹ , Case Rep Dermatol. 2015 Feb 21;7(1):29-35.

 She is the oldest reported case of GPP with a deficiency of interleukin-36 receptor antagonist (DITRA), although GPP in DITRA has been suggested to usually occur in younger cases with no pre-existing psoriasis vulgaris.

https://pubmed.ncbi.nlm.nih.gov/25848350/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357681/pdf/cde-0007-0029.pdf

Tomotaka Mabuchi ¹, Yasuaki Manabe, Hanako Yamaoka, Tami Ota, Masayuki Kato, Norihiro Ikoma, Yoshiyuki Kusakabe, Hirotaka Komaba, Akira Ozawa, J Dermatol. 2014 Jun;41(6):521-4.

 During maintenance HD twice a week, weekly GMA was started at Tokai University Hospital. The skin symptoms disappeared after five administrations of GMA. We suggest that GMA is an effective therapy for GPP patients with ESRD who are treated with HD.

https://pubmed.ncbi.nlm.nih.gov/24815562/

K Sugiura ¹, K Haruna, Y Suga, M Akiyama, J Eur Acad Dermatol Venereol. 2014 Dec;28(12):1835-6.

https://pubmed.ncbi.nlm.nih.gov/24490830/

Shigaku Ikeda ¹, Hidetoshi Takahashi ², Yasushi Suga ³, Hikaru Eto ⁴, Takafumi Etoh ⁵, Keiko Okuma ⁶, Kazuo Takahashi ⁷, Takeshi Kanbara ⁸, Mariko Seishima ⁹, Akimichi Morita ¹⁰, Yasutomo Imai ¹¹, Takuro Kanekura ¹²

J Am Acad Dermatol 2013 Apr;68(4):609-617. doi: 10.1016/j.jaad.2012.09.037. Epub 2013 Jan 17.

Background: Generalized pustular psoriasis (GPP) is a chronic autoimmune disease characterized by fever, erythema, and neutrophilic pustules over large areas of the skin. GPP does not respond well to pharmacologic intervention. Objective: We sought to assess efficacy of selectively depleting the myeloid lineage leukocytes in patients with GPP. Methods: Fifteen patients with persistent moderate to severe GPP despite conventional therapy were included. Eligible patients had more than 10% of their skin area covered by pustules. Treatment with oral etretinate, cyclosporine, methotrexate, prednisolone, and topical prednisolone/vitamin D3 was continued if had been initiated well in advance of study entry. Five sessions of adsorptive granulocyte and monocyte apheresis (GMA) with the Adacolumn (JIMRO Co Ltd, Takasaki, Japan) were administered (1 session/wk over 5 weeks) to selectively deplete Fcγ receptor and complement receptor bearing leukocytes. Efficacy was assessed by measuring the skin areas covered by pustules at baseline and 2 weeks after the last GMA session. Results: One patient did not complete the first GMA session. Based on the GPP severity scores relative to entry, the overall scores improved (n = 14, P = .0027), and the area of erythroderma (P = .0042), pustules (P = .0031), and edema (P = .0014) decreased. Likewise, Dermatology Life Quality Index improved (P = .0016), reflecting better daily function and quality of life. Twelve patients were judged as responders (85.7%), and 10 patients maintained the clinical response for 10 weeks after the last GMA session without any change in medication. Limitations: This study was unblinded and without a placebo arm. Conclusion: GMA in this clinical setting was safe and effective, suggested a major role for granulocytes/monocytes in the immunopathogenesis of GPP.

https://pubmed.ncbi.nlm.nih.gov/23332516/