Chen Shengli, Liu Jifeng
Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2025 May 30;104(22):e42550. doi: 10.1097/MD.0000000000042550.
Psoriasis is an immune-mediated chronic inflammatory skin disease that is rarely complicated by polymyositis in clinical practice. Here, we report a patient with psoriasis, following treatment with Etanercept, who exhibited an increase in creatine kinase (CK) levels and a decline in muscle strength. After combined treatment with methylprednisolone, methotrexate, and Ixekizumab, the psoriasis rash completely subsided and CK levels returned to normal.
The patient was a 22-year-old female with systemic erythema and scale itching for 3 months, and her serum CK level was 1711 U/L without muscle pain and muscle weakness. She was diagnosed with psoriasis and myositis awaiting investigation and was then treated with Etanercept at 50 mg weekly. At the 6-month follow-up with ongoing Etanercept treatment, her serum CK level was elevated to 3465 U/L. Electromyography and thigh magnetic resonance imaging revealed myositis. After methylprednisolone and methotrexate tablet treatment for polymyositis, she developed pulmonary pneumonia, and methotrexate and methylprednisolone tablets were withdrawn. Although the pneumonia was controlled, the facial erythema, plaques, scales, and rash gradually increased and spread all over the body. Moreover, gastrocnemius pain and fatigue persisted. The patient was treated with subcutaneous injection of 160 mg of Ixekizumab combined with methylprednisolone tablet (8 mg/d), after 2 weeks, the dosage was reduced to 80 mg once every 2 weeks, and the patient's psoriastic rash had completely disappeared after 4 weeks. The patient continued to receive subcutaneous injections of Ixekizumab 80 mg once a month and methylprednisolone tablet 6 mg every day. Six months later, no rash recurrence was noted and her CK level was within the normal range.
The patient was diagnosed with psoriasis with polymyositis.
After combined treatment with methylprednisolone, methotrexate, and Ixekizumab, the psoriasis rash completely subsided and CK levels returned to normal.
Our case shows that Ixekizumab is an effective treatment for psoriasis complicated with polymyositis, which is worth clinical application.
Although Etanercept can be used to treat psoriasis and dermatomyositis, it can also aggravate the myositis. Ixekizumab is an effective treatment for psoriasis complicated by polymyositis.
银屑病是一种免疫介导的慢性炎症性皮肤病，在临床实践中很少并发多发性肌炎。在此，我们报告一名银屑病患者，在接受依那西普治疗后，肌酸激酶（CK）水平升高且肌肉力量下降。在联合使用甲泼尼龙、甲氨蝶呤和司库奇尤单抗治疗后，银屑病皮疹完全消退，CK水平恢复正常。
该患者为一名22岁女性，全身红斑伴鳞屑瘙痒3个月，血清CK水平为1711U/L，无肌肉疼痛和肌无力。她被诊断为银屑病合并待查肌炎，随后每周接受50mg依那西普治疗。在持续使用依那西普治疗6个月的随访中，她的血清CK水平升至3465U/L。肌电图和大腿磁共振成像显示为肌炎。在使用甲泼尼龙和甲氨蝶呤片治疗多发性肌炎后，她发生了肺炎，甲氨蝶呤和甲泼尼龙片停用。尽管肺炎得到控制，但面部红斑、斑块、鳞屑和皮疹逐渐增多并蔓延至全身。此外，腓肠肌疼痛和疲劳持续存在。患者接受皮下注射160mg司库奇尤单抗联合甲泼尼龙片（8mg/d）治疗，2周后剂量减至80mg每2周一次，4周后患者的银屑病皮疹完全消失。患者继续每月皮下注射一次80mg司库奇尤单抗，每天口服6mg甲泼尼龙片。6个月后，未观察到皮疹复发，其CK水平在正常范围内。
患者被诊断为银屑病合并多发性肌炎。
联合使用甲泼尼龙、甲氨蝶呤和司库奇尤单抗治疗后，银屑病皮疹完全消退，CK水平恢复正常。
我们的病例表明，司库奇尤单抗是治疗银屑病合并多发性肌炎的有效药物，值得临床应用。
尽管依那西普可用于治疗银屑病和皮肌炎，但它也可能加重肌炎。司库奇尤单抗是治疗银屑病合并多发性肌炎的有效药物。
