Ayub Ibraheim, Ayub Shehzad
Internal Medicine, Yale New Haven Hospital, Waterbury, USA.
Psychiatry, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Cureus. 2024 Jul 23;16(7):e65229. doi: 10.7759/cureus.65229. eCollection 2024 Jul.
Psoriasis is a chronic inflammatory systemic disorder often associated with psychiatric comorbidities such as depression and anxiety. This case report describes a 25-year-old man with schizoaffective disorder, bipolar type, whose suicidal ideation was worsened by a severe psoriasis flare that was induced by the initiation of lithium for psychiatric management. Lithium was switched to valproate, and treatment with secukinumab, an IL-17A inhibitor, was initiated, resulting in significant improvement in both psoriasis and mental health. This case highlights the phenomenon of drug-induced psoriasis, emphasizing the need for a high index of suspicion and careful review of past medical history. It underscores the reciprocal relationship between psoriasis and psychiatric comorbidities, advocating for a tailored approach to treating both conditions to achieve optimal outcomes.
银屑病是一种慢性炎症性全身性疾病,常与抑郁症和焦虑症等精神疾病共病。本病例报告描述了一名25岁的双相型精神分裂症患者,其自杀观念因开始使用锂盐进行精神科治疗而诱发严重银屑病发作而恶化。将锂盐换为丙戊酸盐,并开始使用白细胞介素-17A抑制剂司库奇尤单抗进行治疗,结果银屑病和心理健康均有显著改善。该病例突出了药物性银屑病现象,强调需要高度怀疑并仔细回顾既往病史。它强调了银屑病与精神疾病共病之间的相互关系,主张采用个性化方法治疗这两种疾病以取得最佳效果。