A case of ustekinumab-induced pustular psoriasis was treated with IL-17A inhibitor
We report a case of ustekinumab-induced pustular psoriasis treated with IL-17A inhibitor. A 51-year-old female presented with red plaques and scales for 20 years, with aggravation and pustules for over 10 days. The patient was previously diagnosed with plaque psoriasis, and poorly responded to syste...
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editoiral office of Journal of Diagnosis and Therapy on Dermato-venereology
2024-11-01
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| Series: | Pifu-xingbing zhenliaoxue zazhi |
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| Online Access: | http://pfxbzlx.gdvdc.com/EN/10.3969/j.issn.1674-8468.2024.11.009 |
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| _version_ | 1850120545792688128 |
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| author | LIN Junjie OU Min LI Yang SHE Xinyan CAI Liting GUAN Zepu WANG Xiaohua |
| author_facet | LIN Junjie OU Min LI Yang SHE Xinyan CAI Liting GUAN Zepu WANG Xiaohua |
| author_sort | LIN Junjie |
| collection | DOAJ |
| description | We report a case of ustekinumab-induced pustular psoriasis treated with IL-17A inhibitor. A 51-year-old female presented with red plaques and scales for 20 years, with aggravation and pustules for over 10 days. The patient was previously diagnosed with plaque psoriasis, and poorly responded to systemic medications. After ruling out contraindications, the patient was subcutaneously given 45 mg of ustekinumab, resulting in clearance of the skin lesion. But erythema and scales with pustules appeared all over the body after the fourth treatment. Physical examination revealed scattered red plaques covered with white-silver scales, and Auspitz sign (+) on the head and face. The trunk and limbs were scattered with large erythematous patches and erythematous plaques, covered with various size of dense pustules, in a target-shape with a brown center. Some pustules merged to pus-lake. Pustules with erosive surface were scattered on the vulvar mucosa. Nails appeared thimble-like with nail plate thickening. Histopathology showed hyperkeratosis, parakeratosis, thinning or disappearance of granular layer, psoriasis-like epidermal hyperplasia, Munro and Kogoj microabscesses, papillary dermal edema, vascular dilation, and perivascular lymphocytic infiltration. Diagnosis was pustular psoriasis. After the treatment with topical corticosteroids and 160 mg of ixekizumab, the rashes subsided within 3 days. Afterwards, patient was treated with ixekizumab according to the manufacturer′s instruction, without the development of new lesion during 1-year follow-up. |
| format | Article |
| id | doaj-art-a9090ea03e694f13a2994e4f3f94aa67 |
| institution | OA Journals |
| issn | 1674-8468 |
| language | zho |
| publishDate | 2024-11-01 |
| publisher | editoiral office of Journal of Diagnosis and Therapy on Dermato-venereology |
| record_format | Article |
| series | Pifu-xingbing zhenliaoxue zazhi |
| spelling | doaj-art-a9090ea03e694f13a2994e4f3f94aa672025-08-20T02:35:19Zzhoeditoiral office of Journal of Diagnosis and Therapy on Dermato-venereologyPifu-xingbing zhenliaoxue zazhi1674-84682024-11-01311177878210.3969/j.issn.1674-8468.2024.11.009A case of ustekinumab-induced pustular psoriasis was treated with IL-17A inhibitorLIN Junjie0OU Min1LI Yang2SHE Xinyan3CAI Liting4GUAN Zepu5WANG Xiaohua6Dermatology Hospital, Southern Medical University, Guangzhou 510091, ChinaHuizhou Dermatology Hospital, Huizhou 516008, ChinaDermatology Hospital, Southern Medical University, Guangzhou 510091, ChinaDermatology Hospital, Southern Medical University, Guangzhou 510091, ChinaDermatology Hospital, Southern Medical University, Guangzhou 510091, ChinaDermatology Hospital, Southern Medical University, Guangzhou 510091, ChinaDermatology Hospital, Southern Medical University, Guangzhou 510091, ChinaWe report a case of ustekinumab-induced pustular psoriasis treated with IL-17A inhibitor. A 51-year-old female presented with red plaques and scales for 20 years, with aggravation and pustules for over 10 days. The patient was previously diagnosed with plaque psoriasis, and poorly responded to systemic medications. After ruling out contraindications, the patient was subcutaneously given 45 mg of ustekinumab, resulting in clearance of the skin lesion. But erythema and scales with pustules appeared all over the body after the fourth treatment. Physical examination revealed scattered red plaques covered with white-silver scales, and Auspitz sign (+) on the head and face. The trunk and limbs were scattered with large erythematous patches and erythematous plaques, covered with various size of dense pustules, in a target-shape with a brown center. Some pustules merged to pus-lake. Pustules with erosive surface were scattered on the vulvar mucosa. Nails appeared thimble-like with nail plate thickening. Histopathology showed hyperkeratosis, parakeratosis, thinning or disappearance of granular layer, psoriasis-like epidermal hyperplasia, Munro and Kogoj microabscesses, papillary dermal edema, vascular dilation, and perivascular lymphocytic infiltration. Diagnosis was pustular psoriasis. After the treatment with topical corticosteroids and 160 mg of ixekizumab, the rashes subsided within 3 days. Afterwards, patient was treated with ixekizumab according to the manufacturer′s instruction, without the development of new lesion during 1-year follow-up.http://pfxbzlx.gdvdc.com/EN/10.3969/j.issn.1674-8468.2024.11.009pustular psoriasisdrug rashustekinumabil-12il-23ixekizumab |
| spellingShingle | LIN Junjie OU Min LI Yang SHE Xinyan CAI Liting GUAN Zepu WANG Xiaohua A case of ustekinumab-induced pustular psoriasis was treated with IL-17A inhibitor Pifu-xingbing zhenliaoxue zazhi pustular psoriasis drug rash ustekinumab il-12 il-23 ixekizumab |
| title | A case of ustekinumab-induced pustular psoriasis was treated with IL-17A inhibitor |
| title_full | A case of ustekinumab-induced pustular psoriasis was treated with IL-17A inhibitor |
| title_fullStr | A case of ustekinumab-induced pustular psoriasis was treated with IL-17A inhibitor |
| title_full_unstemmed | A case of ustekinumab-induced pustular psoriasis was treated with IL-17A inhibitor |
| title_short | A case of ustekinumab-induced pustular psoriasis was treated with IL-17A inhibitor |
| title_sort | case of ustekinumab induced pustular psoriasis was treated with il 17a inhibitor |
| topic | pustular psoriasis drug rash ustekinumab il-12 il-23 ixekizumab |
| url | http://pfxbzlx.gdvdc.com/EN/10.3969/j.issn.1674-8468.2024.11.009 |
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