Laboratory of Molecular Neuro-Oncology, Department of Neurology, University Hospital Zurich, 8091 Zürich, Switzerland.
Department of Gastroenterology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Medicina (Kaunas). 2024 Jan 6;60(1):106. doi: 10.3390/medicina60010106.
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.
乌司奴单抗（UST）是一种针对白细胞介素-12 和白细胞介素-23 的生物制剂，广泛用于治疗银屑病和克罗恩病。尽管它具有疗效，但在一些患者的 UST 治疗期间，已经有发生矛盾性银屑病诱导或恶化的情况。本文对报告的 UST 诱导的矛盾性银屑病病例进行了全面回顾，包括我们诊所的一个病例。我们重点关注一位 39 岁的女性患者，她患有长期的克罗恩病，在接受 UST 治疗时出现了银屑病样皮疹，活检结果证实了这一点。该患者的临床历程，从最初诊断到因各种并发症（包括药物诱导的狼疮和随后出现的银屑病表现）进行治疗调整的复杂性，深入了解了此类病例临床管理中遇到的挑战。这篇综述强调了临床医生识别接受 UST 治疗的患者发生矛盾性银屑病的可能性的必要性，并呼吁进一步研究以更好地理解这一现象并制定有效的管理策略。
