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/PMC10818897PMC
http://dx.doi.org/10.3390/medicina60010106DOI Listing

Publication Analysis

Top Keywords

paradoxical psoriasis
16
comprehensive review
8
crohn's disease
8
ust treatment
8
paradoxical
4
psoriasis induced
4
induced ustekinumab
4
ustekinumab comprehensive
4
review case
4
case report
4

Similar Publications

Association Between Biologics and Janus Kinase Inhibitors With Inflammatory Bowel Disease as Paradoxical Reactions: A Real-World Assessment.

United European Gastroenterol J

December 2024

Division of Gastroenterology and Hepatology, NHC Key Laboratory of Digestive Diseases, State Key Laboratory for Oncogenes and Related Genes, School of Medicine, Shanghai Institute of Digestive Disease, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.

Background And Objective: With limited evidence connecting paradoxical inflammatory bowel disease (paradoxical IBD) to the newest biologics and Janus kinase inhibitors, our study aims to investigate the occurrence of paradoxical IBD induced by these agents in treating other immune-mediated inflammatory diseases (IMIDs). We aim to identify associated risk signals, the primary affected population, and the risk profile changes over time.

Methods: We performed disproportionality analysis to evaluate paradoxical IBD risk signals using data from the FDA Adverse Event Reporting System.

View Article and Find Full Text PDF

Inflammatory bowel diseases (IBD) and psoriasis are chronic inflammatory conditions belonging to the heterogeneous group of immune-mediated inflammatory diseases (IMIDs). A significant bidirectional link between these two entities has been observed, conditioning an increased risk of IBD in patients with psoriasis and vice-versa. Biological therapies used for IBD may lead to the occurrence of psoriasis as a "paradoxical reaction.

View Article and Find Full Text PDF

Tumor necrosis factor alpha inhibitors (TNFi) are biological drugs used worldwide to treat various autoimmune disorders. Paradoxically, TNF- antagonists can also induce autoimmune diseases being systemic vasculitis, systemic lupus erythematosus, and psoriasis, the most common. We present a 22-year-old woman with ulcerative colitis (UC) who was started on adalimumab 40 mg subcutaneously every 2 weeks.

View Article and Find Full Text PDF
Article Synopsis
  • * Patients using anti-TNF-α treatments, like adalimumab, often experience paradoxical skin reactions (PSRs), such as rashes and hair loss, necessitating a switch to alternative treatments.
  • * Guselkumab, an anti-IL-23 treatment, not only avoids PSRs but also effectively manages PPP/PAO, and it is suggested as a preferable option over adalimumab for patients dealing with these conditions.
View Article and Find Full Text PDF

Immune mediated inflammatory diseases (IMIDs) are a heterogenous group of inflammatory disorders of joint, skin, and gut characterized by both shared and distinct pathological pathways. This complexity has therapeutic implications, as not all IMIDs exhibit responsiveness to available biologicals. Moreover, cases have been documented where patients undergoing biologic therapy experience paradoxical occurrences of either a new IMID or a flare-up of a previously asymptomatic one.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!