Bratborska Aleksandra Wiktoria, Jałowska Magdalena, Bowszyc-Dmochowska Monika, Kowalczyk Michał J, Adamska Kinga
Department of Dermatology and Venereology, Poznan University of Medical Sciences, Poznan, Poland.
Doctoral School, Poznan University of Medical Sciences, Poznan, Poland.
Front Immunol. 2025 Aug 26;16:1651517. doi: 10.3389/fimmu.2025.1651517. eCollection 2025.
Psoriasis affects approximately 2% of the global population, with plaque psoriasis being its most prevalent manifestation. Management strategies range from topical therapies for mild cases to systemic interventions for moderate to severe cases. Those include immunosuppressive drugs and biological agents, which are novel therapeutic options that have revolutionized psoriasis management. Patients with psoriasis have a higher risk of developing other autoinflammatory diseases, as well as cancer. In addition, both classic immunosuppressive agents and biologics carry a risk of malignancies. We present a case of a 36-year-old male with a long history of plaque psoriasis and psoriatic arthritis. He was undergoing treatment with secukinumab and also had a history of therapy with infliximab. During the treatment course, the patient noted a progressively enlarging pigmented lesion on his left calf, which was subsequently diagnosed as superficial spreading melanoma. Following this diagnosis, he was informed about the potential oncological risks associated with biological therapy and switched to acitretin and methotrexate. Over two years later, he was diagnosed with ulcerative colitis (UC) after endoscopic evaluation. No melanoma recurrence has been observed to date. Our case report demonstrates the difficulties in managing malignancies in patients receiving biologic therapy, highlighting the necessity for careful medical assessment and examination of patients receiving those types of drugs. In cases of cancer coexistence, a multidisciplinary approach is crucial for the sufficient treatment of both oncological and autoinflammatory diseases. Additionally, medical professionals should be aware of the increased risk of developing other autoinflammatory conditions in individuals with psoriasis.
银屑病影响着全球约2%的人口，斑块状银屑病是其最常见的表现形式。治疗策略从轻度病例的局部治疗到中度至重度病例的全身干预。这些包括免疫抑制药物和生物制剂，它们是彻底改变银屑病治疗的新型治疗选择。银屑病患者患其他自身炎症性疾病以及癌症的风险更高。此外，经典的免疫抑制药物和生物制剂都有发生恶性肿瘤的风险。我们报告一例36岁男性，有长期斑块状银屑病和银屑病关节炎病史。他正在接受司库奇尤单抗治疗，也曾接受英夫利昔单抗治疗。在治疗过程中，患者注意到左小腿上一个色素沉着病变逐渐增大，随后被诊断为浅表扩散性黑色素瘤。确诊后，他被告知生物治疗相关的潜在肿瘤风险，并改用阿维A和甲氨蝶呤。两年多后，经内镜评估他被诊断为溃疡性结肠炎（UC）。迄今为止未观察到黑色素瘤复发。我们的病例报告展示了接受生物治疗的患者管理恶性肿瘤的困难，强调了对接受这类药物治疗的患者进行仔细医学评估和检查的必要性。在癌症并存的情况下，多学科方法对于充分治疗肿瘤和自身炎症性疾病至关重要。此外，医学专业人员应意识到银屑病患者发生其他自身炎症性疾病的风险增加。
