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Psoriasis is an immune-mediated chronic inflammatory skin disease and chronic kidney disease is one of the common comorbidities of psoriasis. Ixekizumab, a humanized IgG4 monoclonal antibody, has been approved for the treatment of moderate-to-severe plaque psoriasis in recent years. However, ixekizumab has not been studied in a population of patients with renal insufficiency. We report two cases of plaque psoriasis patients with renal dysfunction successfully treated with ixekizumab without dose reduction，which experience no side effects and does not cause further kidney injury., (© 2024 International Society for Hemodialysis.)

Background: Generalized pustular psoriasis (GPP) is a rare, severe, and sometimes fatal form of childhood psoriasis. The first line therapies include acitretin, cyclosporin A, and methotrexate which take effect slowly and have varying long-term side effects for children. Recently, the anti-tumor necrosis factor-alpha (TNF-α), adalimumab has shown efficacy in adult patients with pustular psoriasis; however, there is lack of evidence of its usage in the pediatric population., Methods: Data on efficacy of adalimumab in treating pediatric GPP along with a literature review are presented., Results: A total of seven patients had marked clearance and reduction in PGA and systemic/laboratory score within the first week of first injection and achieved almost complete clearance of skin lesions by 1-month follow up. In literature, adalimumab treating pustular psoriasis in pediatric has been described in six children who failed in prior treatment. All six patients showed a satisfactory therapeutic effect., Conclusions: Subcutaneous injection of adalimumab every other week in the treatment of children with GPP has significant clinical efficacy with rapid clearance of skin lesions, providing a novel alternative for children with pustular psoriasis who responded poorly to traditional treatment or are not suitable for traditional treatment.