Severe paradoxical generalized pustular psoriasis induced by adalimumab biosimilar successfully treated with brodalumab
Paradoxical psoriasis is a rare but increasingly recognized adverse effect of anti-TNF-α therapy, characterized by the onset or exacerbation of psoriatic lesions in patients treated for other immune-mediated conditions. We report the case of a 47-year-old woman with chronic plaque psoriasis who dev...
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| Language: | English |
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PAGEPress Publications
2025-05-01
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| Series: | Dermatology Reports |
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| Online Access: | https://www.pagepress.org/journals/dr/article/view/10414 |
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| author | Angela Fico Edoardo Mortato Claudia Paganini Marina Talamonti Cosimo Di Raimondo Dionisio Silvaggio Luca Bianchi Marco Galluzzo |
| author_facet | Angela Fico Edoardo Mortato Claudia Paganini Marina Talamonti Cosimo Di Raimondo Dionisio Silvaggio Luca Bianchi Marco Galluzzo |
| author_sort | Angela Fico |
| collection | DOAJ |
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Paradoxical psoriasis is a rare but increasingly recognized adverse effect of anti-TNF-α therapy, characterized by the onset or exacerbation of psoriatic lesions in patients treated for other immune-mediated conditions. We report the case of a 47-year-old woman with chronic plaque psoriasis who developed severe generalized pustular psoriasis (GPP) after six months of treatment with an adalimumab biosimilar. Given the extent and severity of the eruption and following inadequate response to previous conventional therapies, the patient was treated with brodalumab, an IL-17RA inhibitor. Rapid and complete remission of both pustular and plaque psoriasis was achieved and maintained for over 60 weeks. This case supports the efficacy of IL-17 pathway blockade in managing paradoxical GPP and highlights the importance of prompt recognition and appropriate therapeutic switching in severe biologic-induced psoriasis.
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| format | Article |
| id | doaj-art-35bbcbc5ea4a4bacae6c8b4e4e984d22 |
| institution | OA Journals |
| issn | 2036-7392 2036-7406 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Dermatology Reports |
| spelling | doaj-art-35bbcbc5ea4a4bacae6c8b4e4e984d222025-08-20T02:35:32ZengPAGEPress PublicationsDermatology Reports2036-73922036-74062025-05-0110.4081/dr.2025.10414Severe paradoxical generalized pustular psoriasis induced by adalimumab biosimilar successfully treated with brodalumabAngela Fico0https://orcid.org/0009-0006-6352-4831Edoardo Mortato1https://orcid.org/0009-0008-3763-6922Claudia Paganini2https://orcid.org/0009-0003-8623-777XMarina Talamonti3https://orcid.org/0000-0002-3070-4071Cosimo Di Raimondo4https://orcid.org/0000-0003-4691-9381Dionisio Silvaggio5https://orcid.org/0000-0003-0866-914XLuca Bianchi6Marco Galluzzo7https://orcid.org/0000-0002-3424-5175Department of Systems Medicine, University of Rome “Tor Vergata”Department of Systems Medicine, University of Rome “Tor Vergata”Department of Systems Medicine, University of Rome “Tor Vergata”Dermatology Unit, Fondazione Policlinico “Tor Vergata”Dermatology Unit, Fondazione Policlinico “Tor Vergata”Dermatology Unit, Fondazione Policlinico “Tor Vergata”Department of Systems Medicine, University of Rome “Tor Vergata”; Dermatology Unit, Fondazione Policlinico “Tor Vergata”, RomeDepartment of Systems Medicine, University of Rome “Tor Vergata”; Dermatology Unit, Fondazione Policlinico “Tor Vergata”, Rome Paradoxical psoriasis is a rare but increasingly recognized adverse effect of anti-TNF-α therapy, characterized by the onset or exacerbation of psoriatic lesions in patients treated for other immune-mediated conditions. We report the case of a 47-year-old woman with chronic plaque psoriasis who developed severe generalized pustular psoriasis (GPP) after six months of treatment with an adalimumab biosimilar. Given the extent and severity of the eruption and following inadequate response to previous conventional therapies, the patient was treated with brodalumab, an IL-17RA inhibitor. Rapid and complete remission of both pustular and plaque psoriasis was achieved and maintained for over 60 weeks. This case supports the efficacy of IL-17 pathway blockade in managing paradoxical GPP and highlights the importance of prompt recognition and appropriate therapeutic switching in severe biologic-induced psoriasis. https://www.pagepress.org/journals/dr/article/view/10414Paradoxical psoriasisgeneralized pustular psoriasisadalimumab biosimilarbrodalumab |
| spellingShingle | Angela Fico Edoardo Mortato Claudia Paganini Marina Talamonti Cosimo Di Raimondo Dionisio Silvaggio Luca Bianchi Marco Galluzzo Severe paradoxical generalized pustular psoriasis induced by adalimumab biosimilar successfully treated with brodalumab Dermatology Reports Paradoxical psoriasis generalized pustular psoriasis adalimumab biosimilar brodalumab |
| title | Severe paradoxical generalized pustular psoriasis induced by adalimumab biosimilar successfully treated with brodalumab |
| title_full | Severe paradoxical generalized pustular psoriasis induced by adalimumab biosimilar successfully treated with brodalumab |
| title_fullStr | Severe paradoxical generalized pustular psoriasis induced by adalimumab biosimilar successfully treated with brodalumab |
| title_full_unstemmed | Severe paradoxical generalized pustular psoriasis induced by adalimumab biosimilar successfully treated with brodalumab |
| title_short | Severe paradoxical generalized pustular psoriasis induced by adalimumab biosimilar successfully treated with brodalumab |
| title_sort | severe paradoxical generalized pustular psoriasis induced by adalimumab biosimilar successfully treated with brodalumab |
| topic | Paradoxical psoriasis generalized pustular psoriasis adalimumab biosimilar brodalumab |
| url | https://www.pagepress.org/journals/dr/article/view/10414 |
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