Rupioid Psoriasis

Ip, Ken Hiu‐Kan; Cheng, Harriet; Oliver, Fergus

doi:10.1001/jamadermatol.2021.0451

Cited by 7 publications

(13 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The term 'rupioid' is used to describe a well-defined, grossly cone-shaped, circular, thick keratotic lesion resembling the limpet shell or oyster shell [3][4][5][6]. This rupioid clinical aspect of the lesions can be observed in psoriasis, secondary syphilis, Norwegian scabies, HIV, sarcoidosis, reactive arthritis, disseminated histoplasmosis, or acrokeratosis paraneoplastica [4][5][6].…”

Section: Discussionmentioning

confidence: 99%

Pembrolizumab-Induced Rupioid Psoriasis Treated by Apremilast Without Interrupting the Ongoing Antineoplastic Treatment

Ambrogio,

Rubino,

Laface

et al. 2024

Cureus

View full text Add to dashboard Cite

We report the case of a 77-year-old man affected by a poorly differentiated metastatic pulmonary adenocarcinoma who, after the first course of therapy with cisplatin-pemetrexed-pembrolizumab treatment, developed rupioid psoriasis. We decided to discontinue pembrolizumab for four weeks until lesions improved and to start therapy with apremilast (an oral small molecule phosphodiesterase (PDE)4 inhibitor) in combination with systemic methylprednisolone 16 mg/day with consequent tapering until discontinuation in a few weeks.After accomplishing three months of treatment with apremilast, the patient gained complete remission of the rupioid lesions. Pembrolizumab therapy was reintroduced, and cycles were carried out without exacerbating the clinical picture. During the fourth month of therapy with apremilast, it was attempted to stop the treatment despite continuing the therapy with pembrolizumab. As a result, there was a relapse of the erythematous scaling plaques. After the subsequent reintroduction of apremilast, a new remission of the clinical picture occurred despite the absence of interruption of pembrolizumab. As far as we know, this is the second case of rupioid psoriasis induced by immunotherapy with pembrolizumab. Still, while the previous case was undergoing therapy with acitretin and methylprednisone, our patient is the first case treated with apremilast with excellent and rapid remission even after discontinuation and re-administration of pembrolizumab without exacerbation of dermatitis. In addition, the appearance of psoriasis during immunotherapy can be properly treated, which does not contraindicate the continuation of the antineoplastic treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Pembrolizumab-Induced Rupioid Psoriasis Treated by Apremilast Without Interrupting the Ongoing Antineoplastic Treatment

Ambrogio,

Rubino,

Laface

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“… 7 Most hyperkeratotic psoriasis including the ostraceous variety is resistant to topical therapy, while systemic drugs, such as acitretin, cyclosporine, methotrexate, and biologics have been tried with varying results. 7 Adalimumab is a monoclonal antibody against TNF that has been widely used in the treatment of moderate-to-severe chronic plaque psoriasis in adults, especially in patients with psoriatic arthritis. 5 A case showed complete resolution of lesions within 14 weeks after the addition of adalimumab to treat a case of ostraceous psoriasis.…”

Section: Discussionmentioning

confidence: 99%

“…6 Psoriasis may present as intensely hyperkeratotic lesions that include ostraceous, rupioid, and elephantine forms. 2,7 The ostraceous psoriasis is typically characterized by lesions with firm adherent thick scales and a surface resembling an oyster shell, while the rupioid form is characterized by hyperkeratotic cone- 7 Most hyperkeratotic psoriasis including the ostraceous variety is resistant to topical therapy, while systemic drugs, such as acitretin, cyclosporine, methotrexate, and biologics have been tried with varying results. 7 Adalimumab is a monoclonal antibody against TNF that has been widely used in the treatment of moderate-to-severe chronic plaque psoriasis in adults, especially in patients with psoriatic arthritis.…”

Section: Discussionmentioning

confidence: 99%

“…2,7 The ostraceous psoriasis is typically characterized by lesions with firm adherent thick scales and a surface resembling an oyster shell, while the rupioid form is characterized by hyperkeratotic cone- 7 Most hyperkeratotic psoriasis including the ostraceous variety is resistant to topical therapy, while systemic drugs, such as acitretin, cyclosporine, methotrexate, and biologics have been tried with varying results. 7 Adalimumab is a monoclonal antibody against TNF that has been widely used in the treatment of moderate-to-severe chronic plaque psoriasis in adults, especially in patients with psoriatic arthritis. 5 A case showed complete resolution of lesions within 14 weeks after the addition of adalimumab to treat a case of ostraceous psoriasis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Lithium-Associated Generalized Ostraceous Psoriasis Treated with Adalimumab: A Case Report

Yang¹,

Lyu²

2023

CCID

View full text Add to dashboard Cite

Ostraceous psoriasis is a rare variant of psoriasis, characterized by severe hyperkeratotic lesions resembling an oyster shell. Adalimumab is a biological agent that antagonizes tumor necrosis factor (TNF) and is used clinically in plaque psoriasis. Some medications such as lithium carbonate (LC) may aggravate or trigger psoriasis. Here, we describe a case of generalized ostraceous psoriasis associated with lithium carbonate, whose lesions completely improved after discontinuing lithium carbonate and using adalimumab.

show abstract

“…Rupioid psoriasis, a subtype of plaque psoriasis characterised by circular or oval-shaped crusted lesions resembling an oyster shell, can be triggered by certain medications including lithium, beta-blockers and synthetic antimalarials or in association with HIV 1 2. Other conditions that may present with similar cutaneous manifestations include syphilis, scabies, sarcoidosis and disseminated histoplasmosis 3. Extracutaneous disorders associated with psoriasis include metabolic syndrome, obesity, chronic kidney disease, COPD, smoking and diabetes mellites, most of which were present in our patient 4.…”

Section: Descriptionmentioning

confidence: 99%