Rapid response to secukinumab in a 5-year-old with deficiency of the interleukin-36 receptor antagonist (DITRA) with severe scalp and nail involvement

Deficiency of the interleukin-36 receptor antagonist (DITRA) is an autosomal recessive disease caused by mutations of the IL36RN gene. DITRA is characterized by acute generalized pustular psoriasis (GPP), fever, systemic inflammation, and leukocytosis. We report the case of a 5-year-old girl with severe scalp and nail involvement with a rapid response to secukinumab.