Recalcitrant paradoxical pustular psoriasis induced by infliximab: Two case reports

paythelady.612 shared this article with you from Inoreader Recalcitrant paradoxical pustular psoriasis induced by infliximab: Two case reports Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3655-3661. doi: 10.12998/wjcc.v9.i15.3655. ABSTRACT BACKGROUND: Paradoxical psoriasis induced by tumor necrosis factor alpha antagonists is a rare side effect of those drugs and has similarities with and differences from classical psoriasis in clinical and pathological characteristics. Treating severe paradoxical psoriasis is challenging because the reported cases are rare, with treatment experience being only anecdotal. CASE SUMMARY: We report 2 cases of paradoxical psoriasis caused by infliximab. Both cases manifested with a significant number of pustular lesions and had protracted and complicated clinical courses. In case 1, secukinumab alone could not control the eruptions, but colchicine supplementation markedly decreased disease activity. In case 2 miscellaneous medications were administered, including the systemic drug acitretin, the immunosuppressive drug cyclosporine, and the biologi c agent ustekinumab. However, multiple applications of those medications failed to prevent new lesions from occurring. Both cases showed moderate-to-high anti-nuclear antibody titers. CONCLUSION: Based on these cases, moderate-to-high anti-nuclear antibody titer seems to be a risk factor for paradoxical psoriasis. In addition, extensive pustular presentation may be a negative prognostic indicator and may portend a protracted clinical course refractory to therapy. PMID:34046466 | PMC:PMC8130067 | DOI:10.12998/wjcc.v9.i15.3655 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.