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Introduction: Psoriatic alopecia is considered a type of hair loss occurring in patients with psoriasis. Adalimumab is a fully humanized recombinant anti-TNF-alpha monoclonal antibody approved for treatment of psoriasis and psoriatic arthritis (PsA), rarely related to the occurrence of dermatological disorders. Case Presentation: We report the case of a 56-year-old female with PsA developing psoriatic alopecia and paradoxical psoriasis induced by adalimumab and successfully treated switching to certolizumab, evaluating response at both thrichoscopy and in vivo reflectance confocal microscopy. Discussion: Among anti-TNF-α agents, certolizumab is the least involved in the development of paradoxical reactions such as psoriatic alopecia and showed to be an effective and safe alternative therapeutic options to manage psoriasis and PsA minimizing the risk of paradoxical reactions.
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Hidradenitis suppurativa (HS) is an inflammatory skin disease showing a chronic-remitting course. It has been rarely reported that long-term inflammation in HS could lead to serious complications like cutaneous squamous cell carcinoma. Cemiplimab is a fully human antibody immunotherapy that inhibits programmed cell death protein-1, approved for the treatment of locally advanced squamous cell carcinoma, or metastatic squamous cell carcinoma, in patients not eligible for curative surgery or radiotherapy. Herein, we report the case of a 56-year-old patient developing an invasive SCC on longstanding and unresponsive HS lesions successfully treated with cemiplimab.
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Desodorantes , Remoção de Cabelo , Hidradenite Supurativa , Humanos , Inquéritos e Questionários , AxilaAssuntos
Antirreumáticos , Artrite Psoriásica , Humanos , Certolizumab Pegol/efeitos adversos , Artrite Psoriásica/tratamento farmacológico , Antirreumáticos/uso terapêutico , Alopecia/induzido quimicamente , Alopecia/diagnóstico , Alopecia/tratamento farmacológico , Polietilenoglicóis/uso terapêutico , Resultado do TratamentoRESUMO
A 74-year-old woman presented with a 30-day history of blisters and erosions in the oral cavity, trunk, and left eye conjunctival mucosa, also reporting a weight loss of 15 kg in the last 3 months. Histopathological examination showed subepidermal blisters and lymphocytic infiltrates with rare eosinophils in the superficial dermis. Direct immunofluorescence showed linear deposits of IgG and C3 along the dermal-epidermal junction and salt-split skin indirect immunofluorescence confirmed the presence of linear deposits of IgG along the blister floor. Indirect immunofluorescence revealed antibodies against laminin 332 using recombinant laminin 332 expressed in human HEK293 cells, and commercial ELISA kits (Euroimmun, Padova, Italy) did not reveal antibodies against BP230 and BP180 antigens. Anti-laminin 332 mucous membrane pemphigoid (MMP), a condition often associated with a hidden neoplasm, was diagnosed. In our case, the paraneoplastic nature of MMP was excluded. Thus, topical treatment with triamcinolone acetonide 0.1% in orabase once daily for 30 days, oral prednisone 0.75 mg/kg/day and rituximab were started to relieve symptoms. Conjunctival, nasal and oral erosions improved, as well as skin lesions, but later the patient was tracheotomized due to respiratory distress linked to the appearance of pharyngolaryngeal synechiae.
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Circinate (Lapière) psoriasis represents a rare variety of generalized subacute pustular psoriasis clinically characterized by rapid onset of annular circinate lesions with micro-pustules at the borders without classic plaque psoriasis manifestations. Most reported cases have been described in childhood with a relative benign course, fast and long-term remission after treatment. However, the recalcitrant course may result in an important negative impact on patients' quality of life. Many systemic treatments have been reported for the management of moderate to severe forms, with variable clinical outcomes. However, data about the use of biologics in this rare psoriasis subtype are still lacking. Herein, we report the first case of circinate psoriasis unresponsive to methotrexate and almost all classes of biologics approved for psoriasis (anti-tumour necrosis factor (TNF), anti-interleukin (IL)-12/23, and anti-IL-17) which was successfully treated with risankizumab (anti-IL-23).
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Exantema , Linfoma , Masculino , Humanos , Testículo , Exantema/diagnóstico , Exantema/etiologia , Erros de DiagnósticoRESUMO
[This corrects the article DOI: 10.3389/fmed.2022.1000954.].