Yatsuzuka Kazuki, Muto Jun, Yoshida Satoshi, Shiraishi Ken, Fujisawa Yasuhiro
Department of Dermatology, Ehime University Graduate School of Medicine, Toon, JPN.
Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, JPN.
Cureus. 2025 May 20;17(5):e84452. doi: 10.7759/cureus.84452. eCollection 2025 May.
Superimposed linear psoriasis is an uncommon form of psoriasis characterized by linear skin lesions aligned with Blaschko's lines, appearing in conjunction with typical psoriatic plaques. This variant is believed to involve cutaneous mosaicism and often shows differential treatment responses between linear and conventional lesions. We present the first case of superimposed linear psoriasis that was resistant to several biologic agents but responded favorably to bimekizumab, a monoclonal antibody targeting both interleukin (IL)-17A and IL-17F. A 33-year-old Japanese male with widespread plaque psoriasis developed a persistent, itchy linear lesion on his right thigh despite prior treatment with cyclosporine and multiple biologics, including ustekinumab, guselkumab, and risankizumab. While generalized psoriasis improved with IL-23 inhibitors, the linear component remained unaffected. Upon initiating bimekizumab at age 45, the patient achieved remission of classical plaque psoriasis within four weeks, and the linear lesion showed marked improvement over a year. This case highlights the potential utility of dual IL-17A/F inhibition in treating this rare and difficult-to-manage psoriasis subtype and suggests a need for further clinical evaluation in larger patient populations.
叠加性线状银屑病是一种罕见的银屑病形式，其特征为与布拉斯科线排列一致的线状皮肤损害，常与典型的银屑病斑块同时出现。这种变异型被认为涉及皮肤镶嵌现象，并且线状损害和传统损害之间常常表现出不同的治疗反应。我们报告首例叠加性线状银屑病病例，该病例对多种生物制剂耐药，但对靶向白细胞介素（IL）-17A和IL-17F的单克隆抗体比美吉珠单抗反应良好。一名33岁的日本男性患有广泛的斑块状银屑病，尽管先前接受过环孢素以及包括乌司奴单抗、古塞库单抗和司库奇尤单抗在内的多种生物制剂治疗，但右大腿仍出现持续瘙痒的线状损害。虽然使用IL-23抑制剂后全身性银屑病有所改善，但线状损害仍未受影响。45岁开始使用比美吉珠单抗治疗后，患者在四周内实现了经典斑块状银屑病的缓解，线状损害在一年内也有显著改善。该病例凸显了双重抑制IL-17A/F在治疗这种罕见且难以管理的银屑病亚型方面的潜在效用，并表明需要在更大规模的患者群体中进行进一步的临床评估。
