Dermatologic Clinic, D.I.S.S.A.L., Genoa University, Genoa, Italy.
Eur Rev Med Pharmacol Sci. 2024 Sep;28(18):4298-4301. doi: 10.26355/eurrev_202409_36787.
The use of biologic agents, mainly tumor necrosis factor (TNF)-α and interleukin (IL)-17A inhibitors, was associated with cutaneous side effects, but the factors associated with eczematous reactions occurring during biologic treatments are not completely known.
An observational, retrospective, multicentre Italian study evaluated the clinical features and the management of eczematous eruptions in 54 patients with chronic plaque psoriasis who developed eczema after treatment with biological agents (anti-IL-17 or 23).
Many of these patients had personal and family history of atopy. Eczematous reactions developed between a few days and 3 years after initiation of the biologic drug. The highest proportion of cases associated with eczematous reactions during biologic treatments was seen in patients on anti-IL-17 agents, including brodalumab. We observed that eczema rapidly remitted without relapse in all patients who switched to anti-IL-23 agents. Among our cases, fast responders to psoriasis therapy seem to have more persistent eczematous reactions.
Patients with psoriasis and a history of atopic dermatitis should be treated with an IL-23 inhibitor due to its efficacy in psoriasis and the rarely reported eczematous reaction.
生物制剂的使用，主要是肿瘤坏死因子（TNF）-α 和白细胞介素（IL）-17A 抑制剂，与皮肤副作用有关，但与生物治疗期间发生湿疹样反应相关的因素尚不完全清楚。
一项观察性、回顾性、多中心意大利研究评估了 54 例慢性斑块型银屑病患者在接受生物制剂（抗 IL-17 或 23）治疗后出现湿疹时的临床特征和管理。
这些患者中有许多有特应性皮炎的个人和家族史。湿疹样反应在开始使用生物药物后几天至 3 年内发生。在生物治疗期间发生湿疹样反应的病例中，抗 IL-17 药物（包括 brodalumab）的比例最高。我们观察到，所有转换为抗 IL-23 药物的患者的湿疹均迅速缓解且无复发。在我们的病例中，对银屑病治疗快速反应的患者似乎有更持久的湿疹样反应。
由于其在银屑病中的疗效和罕见报道的湿疹样反应，有特应性皮炎病史的银屑病患者应接受 IL-23 抑制剂治疗。
