{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T22:36:27Z","timestamp":1792708587497,"version":"4.5.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T00:00:00Z","timestamp":1726790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T00:00:00Z","timestamp":1726790400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Generalized pustular psoriasis (GPP) is a recurrent and sometimes life\u2010threatening sterile pustular disease. Because interleukin (IL)\u201036 is the central cytokine in disease formation, spesolimab, which interferes with IL\u201036 receptor signaling, is highly effective. Here, we report a patient with GPP with a heterozygous hypomorphic\n                    <jats:italic>MPO<\/jats:italic>\n                    variant refractory to intravenous spesolimab. Although spesolimab showed excellent clinical efficacy in resolving pre\u2010existing pustules and erythema, it did not suppress the emergence of new pustules and erythema, which did not decrease the peripheral blood neutrophil count, therefore bimekizumab, an anti\u2010IL\u201017A\/IL\u201017F antibody, was administered after the second spesolimab infusion, which resolved the pustules and erythema. We discuss the possible reasons for the resistance mechanism to spesolimab.\n                  <\/jats:p>","DOI":"10.1111\/1346-8138.17464","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T06:33:52Z","timestamp":1726814032000},"page":"167-170","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Generalized pustular psoriasis patient with a heterozygous hypomorphic\n                    <i>MPO<\/i>\n                    variant refractory to intravenous spesolimab"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2635-888X","authenticated-orcid":false,"given":"Youichi","family":"Ogawa","sequence":"first","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine University of Yamanashi  Yamanashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eri","family":"Maejima","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine University of Yamanashi  Yamanashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5958-2875","authenticated-orcid":false,"given":"Takuya","family":"Takeichi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1228-603X","authenticated-orcid":false,"given":"Takashi","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine University of Yamanashi  Yamanashi 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