Background: Generalized pustular psoriasis (GPP) is a severe and disabling variant of psoriasis. The treatment of GPP is challenging, often characterized by side effects or unsatisfactory response. Etanercept is a tumor necrosis factor α blocking agent that demonstrated a consistent efficacy in the control of psoriasis. Objectives: We aimed to evaluate the efficacy and safety profile of etanercept at different dosages in GPP. Methods: Six patients affected by GPP, unresponsive to conventional treatment, received etanercept subcutaneously at the dosages of 25 and 50 mg biweekly for 48 weeks. Results: Our experience led to the observation that the administration of etanercept 50 mg biweekly is an effective dosage, characterized by good efficacy and rapidity of effect. Patients who were continuously treated at this dosage for 24 weeks presented stable conditions and long-term maintenance until week 48 even after a dose reduction to 25 mg. Conclusion: We demonstrated a good and durable efficacy of etanercept in patients affected by GPP.

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