98%
921
2 minutes
20
Ustekinumab (UST), a biologic agent targeting interleukin-12 and interleukin-23, is widely used in the management of psoriasis and Crohn's disease. Despite its efficacy, there have been instances of paradoxical psoriasis induction or exacerbation in some patients during UST therapy. This paper offers a comprehensive review of reported cases of UST-induced paradoxical psoriasis, including a case from our clinic. We focus on a 39-year-old female patient with a history of long-standing Crohn's disease who developed a psoriasiform rash, as confirmed by biopsy, while undergoing UST treatment. The patient's clinical journey, from initial diagnosis through the complexities of treatment adjustments due to various complications including drug-induced lupus and the subsequent onset of psoriatic manifestations, provides insight into the challenges encountered in the clinical management of such cases. This review emphasizes the necessity for clinicians to recognize the possibility of paradoxical psoriasis in patients receiving UST treatment and calls for further research to better understand this phenomenon and devise effective management strategies.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10818897 | PMC |
http://dx.doi.org/10.3390/medicina60010106 | DOI Listing |
Clin Cosmet Investig Dermatol
September 2025
Department of Dermatology, The Fifth People's Hospital of Hainan Province, Haikou, Hainan, People's Republic of China.
With the widespread long-term use of biologics in plaque psoriasis, reports of paradoxical eczema caused by interleukin-17A (IL-17A) monoclonal antibodies are increasing. This paradoxical eczema (PE) can occasionally require termination of biologic treatment, which may result in suboptimal management of psoriasis and increased risk of disease flare-ups. In the context of PE, therapeutic strategies should prioritize agents with dual efficacy against both the primary inflammatory process and paradoxical dermatitis, such as Janus kinase (JAK) inhibitors, which modulate key cytokine pathways implicated in both conditions.
View Article and Find Full Text PDFBiomedicines
August 2025
Concept Life Sciences, Edinburgh EH16 4UX, UK.
Immune checkpoint inhibitor therapy in patients with lung cancer and metastatic melanoma is associated with exacerbation of autoimmune-related diseases. The efficacy of treatment targeting the programmed cell death receptor-1 (PD-1) checkpoint relies upon a feedback loop between interferon gamma (IFN-γ) and the interleukin-12 isoform, IL-12p40. Paradoxically, both cytokines and the anti-PD-1 antibody worsen psoriasis.
View Article and Find Full Text PDFCureus
July 2025
Dermatology, Fukushima Medical University, Fukushima, JPN.
Pustular psoriasis is a rare subtype of psoriasis, classified into two broad forms: generalized and localized. In the present study, we retrospectively analyzed 41 cases of pustular psoriasis over a 15-year period at a single institution. There were 38 cases of generalized and three cases of localized pustular psoriasis.
View Article and Find Full Text PDFInflammopharmacology
August 2025
School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Background: Lichen planus (LP) is a group of chronic inflammatory disorders of the skin, mucous membranes, scalp, and nails that mainly affect the middle-aged population. Inflammatory modifiers, including interferon-α (IFN-α), IFN-γ, tumor necrosis factor-alpha (TNF-α), as well as various interleukins (ILs), such as IL-4, IL-5, IL-6, IL-8, IL-9, IL-10, IL-12, IL-17, IL-18, IL-21, IL-22, and IL-23 has also been suggested to contribute in the LP pathogenesis. We aim to systematically evaluate the effect of IL inhibitors on treating and triggering LP disease.
View Article and Find Full Text PDFRheumatol Int
August 2025
Department of Dermatology and Venereology, Medical University of Bialystok, Żurawia 14, Bialystok, 15-540, Poland.
Ixekizumab is a monoclonal antibody used in the treatment of moderate-to-severe psoriasis and psoriatic arthritis by targeting interleukin-17 A (IL-17 A). It has demonstrated efficacy in controlling inflammation in autoimmune diseases, though adverse reactions can arise. This case study reports a case of 25-year-old female with psoriatic arthritis undergoing treatment with ixekizumab, who developed acute enlargement and inflammation of a pre-existing sebaceous cyst located posterior to the left auricle, occurring two days after the administration of a routine ixekizumab dose.
View Article and Find Full Text PDF