Yang Qingqing, Lyu Jiajie, Gui Yu, Yu Shuling, Chen Jiajie, Zhang Haoxue, Liu Shengxiu
Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Anhui, Hefei, 230032, China.
Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Anhui, 230032, Hefei, China.
Allergy Asthma Clin Immunol. 2023 Jul 5;19(1):59. doi: 10.1186/s13223-023-00811-5.
Secukinumab has been approved by the U.S. FDA and the European Medicines Agency for the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis with the documented adverse effects. Here we reported in one case that a new symptom, Prurigo Nodularis (PN), developed during the programmed dosing of secukinumab.
A 22-years-old male with a 6-month history of severe plaque psoriasis vulgaris was presented to the dermatology clinic two weeks after the fifth serial weekly doses of secukinumab, for the reason of the outbreaks of multiple erythematous papules and pruritus nodules on the trunk and extremities. Physical examination showed that psoriatic rash were under effective control with the previous targeted therapy of secukinumab for plaque psoriasis vulgaris, but new dermatologic condition was spotted with multiple edematous red firm papules on the trunk and extremities, in the form of soy or hemispherical nodules, red in color, firm to touch, with some ulcerated crusts visible at tops, but negative Auspitz sign. Pathological examination confirmed these papules as PN.
This case report is shared to inform clinicians about an unannounced adverse effect of the secukinumab in the treatment of psoriasis, and it is recommended that patients be carefully informed of the possible risk of PN before starting treatment.
司库奇尤单抗已获美国食品药品监督管理局（FDA）和欧洲药品管理局批准，用于治疗中度至重度斑块状银屑病和银屑病关节炎，且有文献记载其不良反应。在此，我们报告了1例在司库奇尤单抗按计划给药期间出现新症状——结节性痒疹（PN）的病例。
一名22岁男性，有6个月重度寻常型斑块状银屑病病史，在连续第5周每周注射司库奇尤单抗后两周，因躯干和四肢出现多个红斑丘疹及瘙痒性结节而就诊于皮肤科门诊。体格检查显示，之前针对寻常型斑块状银屑病的司库奇尤单抗靶向治疗有效控制了银屑病皮疹，但发现了新的皮肤病情况，躯干和四肢有多个水肿性红色坚实丘疹，呈黄豆或半球形结节状，颜色发红，触之坚实，顶部可见一些溃疡结痂，但奥氏征阴性。病理检查证实这些丘疹为PN。
分享本病例报告是为了让临床医生了解司库奇尤单抗治疗银屑病时出现的一种未公布的不良反应，建议在开始治疗前仔细告知患者发生PN的可能风险。
