Atopic-like dermatitis after secukinumab injection: A case report

Abstract

Psoriasis is a chronic, immune-mediated inflammatory skin disease which is associated with a substantial detriment to physical and psychological quality of life (Cozzani et al., 2010). For this reason, it is imperative to find an effective and safe therapy.A new class of biologic therapy that targets IL-17A has been discovered. One of these agents, secukinumab (Novartis Pharmaceuticals), is an injectable, fully human monoclonal antibody and was recently approved by the US Food and Drug Administration for treat-

Eczematous eruption during anti‐interleukin 17 treatment of psoriasis: an emerging condition

“…reported the first case of EE occurring after the administration of ustekinumab and recently Burlando et al . observed a case of atopic‐like dermatitis occurring after every secukinumab injection for 6 months . EE resulting from anti‐TNF‐α treatment has been previously described .…”

“…Eczematous eruption (EE) has been previously reported in 5–20% of patients with various inflammatory diseases treated with anti‐TNF‐α . Conversely, only anecdotal cases of EE induced by anti‐IL‐12/23 or anti‐IL‐17 in patients with psoriasis have been described …”

“…The pathogenesis of EE with biologic use is not clear. Psoriasis and eczema are diseases caused by an imbalance in the T helper (Th)1/Th2 immune response, with Th1 being more prominent in psoriasis and Th2 in eczema . It is thought that the Th1 and Th2 pathways are closely related in that when the Th1 response is blocked or decreased, the Th2 balance will in turn increase, and vice versa .…”

The Role of Th17-Related Cytokines in Atopic Dermatitis

“…There have been anecdotal case reports showing exacerbation of AD-like dermatitis after treatment with anti-IL17 antibody for psoriasis [57][58][59]. A 31-year-old man with severe psoriasis treated with ixekizumab presented with a one-month history of pruritic lesions [57].…”

“…Ixekizumab may suppress the expression of keratinocyte-derived AMPs, increasing the risk of bacterial and fungal infection, which can lead to the eczematous phenotype. Another group reported a 70-year-old woman with intractable psoriasis vulgaris treated with 300 mg of secukinumab [58]. Six months after the first dose of secukinumab was administered, psoriasis lesions were cleared.…”