G Caldarola1,2, F Pirro1,2, A Di Stefani1,2, M Talamonti3, M Galluzzo3, S D'Adamio3, M Magnano4, N Bernardini5, P Malagoli6, F Bardazzi4, C Potenza5, L Bianchi3, K Peris1,2, C De Simone1,2. 1. Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy. 2. Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 3. Dermatology Unit, University of Rome "Tor Vergata", Rome, Italy. 4. Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy. 5. Dermatology Unit, Sapienza University of Rome, Polo Pontino, Terracina, Italy. 6. Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy.
Abstract
Background: Real-life data often highlight the side effects of certain drugs not previously reported in randomized controlled trials (RCTs).Objective: To describe cutaneous inflammatory eruptions in psoriatic patients treated with an anti IL-17A agent (secukinumab or ixekizumab). Methods: Retrospective analysis of a cohort of patients with chronic plaque psoriasis who started an anti IL-17A agent between September 2016-February 2019 and who developed cutaneous inflammatory eruptions during treatment. A systematic review of similar events reported in the literature was performed. Results: Data of 468 patients were reviewed and 27 cutaneous inflammatory eruptions of 27 (5.8%) patients were collected. The eruptions appeared after a mean of 16.9 ± 17.0 weeks of therapy showing a classical acute eczema in 11 patients (40.7%), an atopic dermatitis-like rash in 11 patients (40.7%) and a psoriasiform eruption in 5 patients (18.5%). Histopathology of 12/27 cases showed epidermal spongiosis in all these variants. Conclusion: We described the clinic-pathologic features of some eczematous eruptions occurring in psoriatic patients, 3-4 months after treatment initiation with an anti IL-17A agent. Further investigations are needed to explain this phenomenon, that might be defined a paradoxical adverse event, based upon the role of IL17 in eczema pathogenesis.
Background: Real-life data often highlight the side effects of certain drugs not previously reported in randomized controlled trials (RCTs).Objective: To describe cutaneous inflammatory eruptions in psoriaticpatients treated with an anti IL-17A agent (secukinumab or ixekizumab). Methods: Retrospective analysis of a cohort of patients with chronic plaque psoriasis who started an anti IL-17A agent between September 2016-February 2019 and who developed cutaneous inflammatory eruptions during treatment. A systematic review of similar events reported in the literature was performed. Results: Data of 468 patients were reviewed and 27 cutaneous inflammatory eruptions of 27 (5.8%) patients were collected. The eruptions appeared after a mean of 16.9 ± 17.0 weeks of therapy showing a classical acute eczema in 11 patients (40.7%), an atopic dermatitis-like rash in 11 patients (40.7%) and a psoriasiform eruption in 5 patients (18.5%). Histopathology of 12/27 cases showed epidermal spongiosis in all these variants. Conclusion: We described the clinic-pathologic features of some eczematous eruptions occurring in psoriaticpatients, 3-4 months after treatment initiation with an anti IL-17A agent. Further investigations are needed to explain this phenomenon, that might be defined a paradoxical adverse event, based upon the role of IL17 in eczema pathogenesis.
Entities:
Keywords:
IL17; Psoriasis; anti IL17; eczematous reactions; ixekizumab; secukinumab; side effects
Authors: Rinkesh K Gupta; Donald T Gracias; Daniela Salgado Figueroa; Haruka Miki; Jacqueline Miller; Kai Fung; Ferhat Ay; Linda Burkly; Michael Croft Journal: Sci Immunol Date: 2021-11-19