Psoriasis is a chronic immunologically associated inflammatory skin disease associated with systemic concomitant diseases, including arthritis, cardiovascular disease, kidney disease, diabetes mellitus and metabolic syndrome. The evolution of ideas about the essence of this dermatosis has led to the concept of a “psoriatic march”: psoriasis as a chronic inflammatory disease is associated with a systemic pathological process. According to numerous epidemiological studies, up to 5–7 % of the world’s population suffer from psoriasis with a continuing increase in the incidence, including severe and torpid phenotypes that lead to the most able-bodied segments of the population becoming disabled. In recent years, the question arises more often of states comorbid to psoriasis. Dermatosis is often combined with cardiovascular diseases (CVD), mental disorders, immune-mediated diseases such as Crohn’s disease, lupus erythematosus. The main factor contributing to the formation of comorbidity in psoriasis is the commonality of some links in the pathogenesis of dermatosis and the listed diseases.

Facial skin lesions in psoriasis, one of the most common dermatoses, are traditionally considered a relatively rare manifestation of the disease, especially in adult patients, but according to modern data, it is observed in at least 40 % of patients. It is believed that facial skin lesions are more typical for young patients with severe widespread skin lesions, involvement of the nail plates and a protracted course. Localization of rashes on the skin of the face – in a cosmetically and socially significant area – is accompanied by significant impairments in the quality of life of patients. The treatment of facial psoriasis is difficult, and few algorithms have been developed for the management of patients with facial psoriatic lesions. We present a patient with psoriasis involving facial skin that first developed after discontinuation of systemic therapy with an IL-17A inhibitor (ixekizumab). During the follow-up of the patient, it became necessary to re-administer systemic biological therapy with the potential risk of an escape effect. In the article, we discuss the clinical manifestations of facial psoriasis and the impact on the quality of life of patients. A description of the observation of a patient with lesions of the facial skin in severe plaque psoriasis and the role of biological therapy in this direction is presented.

No abstract

No abstract

No abstract