Therapeutic challenges of psoriasis in the HIV‑infected patient: A case report

Arbune, Manuela; Arbune, Anca-Adriana; Niculeț, Elena; Anghel, Lucreția; Fotea, Silvia; Tatu, Alin Laurențiu

doi:10.3892/etm.2021.11098

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…In the context of HIV infection, the onset or worsening of psoriasis could reflect the direct impact of viral infection on cytokine balance and the cell-mediated inflammatory processes associated with the immune regeneration following antiretroviral therapy. 6 A topical or UVB-based approach is usually not an adequate option to achieve remission in cases characterized by high severity. Therefore, systemic treatment becomes mandatory to restore proper quality of life and to avoid potential musculoskeletal and cardiovascular involvement.…”

Section: Discussionmentioning

confidence: 99%

“…4 They showed excellent efficacy and safety profile in clinical trials; however, data on PLHIV are extremely limited. 5 We report four male patients with concomitant psoriasis and HIV infection who were successfully treated with risankizumab, an anti-IL-23 monoclonal antibody.…”

Section: Introductionmentioning

confidence: 99%

“… 4 They showed excellent efficacy and safety profile in clinical trials; however, data on PLHIV are extremely limited. 5 …”

Section: Introductionmentioning

confidence: 99%

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Effectiveness and safety of risankizumab in HIV patients with psoriasis: A case series

Orsini,

Maramao,

Gargiulo

et al. 2023

Int J STD AIDS

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Biological therapies represent the gold-standard treatment of severe forms of plaque psoriasis. However, people living with HIV are often under-treated for psoriasis because very limited data are available on the use of biologics in this population. We report four cases of patients affected by HIV and moderate-to-severe plaque psoriasis, all treated with risankizumab, a monoclonal antibody that selectively targets interleukin-23. After 16 weeks, all patients experienced complete or almost complete skin clearance without any adverse events. Data on the effectiveness and safety of biological therapies in people living with HIV are limited to case reports or small case series, especially for the most recently approved inhibitors of interleukin-23. Our experienced, although limited, supports the role of risankizumab as a safe and effective therapy for psoriasis amongst patients living with HIV.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness and safety of risankizumab in HIV patients with psoriasis: A case series

Orsini,

Maramao,

Gargiulo

et al. 2023

Int J STD AIDS

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“…10,11 Psoriasis exacerbation in HIV disease may be effectively treated with antiretroviral therapy. 12,13 Psoriasis has also been associated with hepatitis C infection. 1 In this patient, the patient did not have fever, cough, painful of swallowing, and on physical examination, there was no hyperemic pharyng and tonsil, tonsil size was T1-T1, so the possibility of streptococcal infection could be ruled out.…”

Section: Discussionmentioning

confidence: 99%

Exacerbation of Psoriasis Vulgaris Induced by Vaccine COVID-19 in HIV Patient: A Case Report

2022

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Background: Psoriasis is a chronic and inﬂammatory skin disease. Many triggering factors can cause exacerbation of psoriasis, such as infection, trauma, and drugs. Several vaccines are known to cause new lesions or exacerbation of psoriasis, including Bacillus Calmette-Guerin (BCG), influenza, tetanus-diphtheria, and pneumococcal polysaccharide. In the COVID-19 pandemic, the COVID-19 vaccine is known to cause the appearance of new lesions or exacerbation of psoriasis. Case presentation: A woman, 31 years old, came to the clinic with itchy reddish patches with white scales on her face, chest, stomach, back, arms, and both legs, and increased since 2 weeks ago. Previously, the patient got the first COVID-19 vaccine (Sinovac), and three days later, red patches appeared with white scales on the chest, stomach, and back. The patient had been diagnosed with psoriasis 3 years ago. Dermatology examination showed reddish patches with white scales on the face, chest, stomach, back, arms, and both legs. Auspitz sign and Kaarvetsvlek phenomen were positive. PASI score was 9,2. Dermoscopy examination showed red dot distribution on light pink background and white scales. She was treated with desoximetasone cream 0,05% twice a day and cetirizine tablet 10 mg once a day. After 2 months of therapy, reddish patches were decreased, and the PASI score was 6,9. Conclusion: COVID-19 vaccine can cause exacerbations in psoriasis patients, but this vaccine can still be given to psoriasis patients. It is based on the documented eﬃcacy of the COVID-19 vaccine in the prevention of severe COVID-19 infection and fatality. Psoriasis patients should be consulted before getting vaccinated for COVID-19, and prompt clinical visits should be available if exacerbation develops.

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“…1,2 In fact, HIV infection can be both a trigger and an exacerbating factor for psoriasis. 3,4 Managing psoriasis in people living with HIV (PLHIV) presents a unique challenge. Topical therapies, highly active antiretroviral therapy (HAART) and phototherapy are the first-line therapeutic options in these individuals, with oral retinoids used as second-line treatment.…”

Section: Introductionmentioning

confidence: 99%

Risankizumab, a therapeutic alternative for psoriasis in people living with HIV

Estevinho,

Freitas,

Torres

2024

J Int Med Res

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The management of psoriasis in individuals with human immunodeficiency virus (HIV) presents a unique challenge, marked by a more severe progression and limited efficacy of first- and second-line treatments. Although conventional systemic therapies might be considered, these agents are immunosuppressants, making their use challenging in people living with HIV (PLHIV). Biologic agents are frequently used in individuals with moderate-to-severe psoriasis, but their efficacy and safety data in PLHIV are very limited, as this patient group tends to be excluded from clinical trials. Risankizumab is a selective interleukin-23 (IL-23) inhibitor that has demonstrated a favourable safety profile and high efficacy in long-term studies and clinical practice. This current case report presents two clinical cases of PLHIV with plaque psoriasis who were effectively treated with the biologic agent risankizumab, with no reported safety issues. Although there are limited data on the use of biologics in PLHIV, this case series suggests that IL-23 inhibitors, namely risankizumab, might be a valuable therapeutic option for this population. Additional research and larger studies are needed to gain a more comprehensive understanding of the long-term safety and efficacy of IL-23 inhibitors in individuals affected by HIV.

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Therapeutic challenges of psoriasis in the HIV‑infected patient: A case report

Cited by 9 publications

References 22 publications

Effectiveness and safety of risankizumab in HIV patients with psoriasis: A case series

Effectiveness and safety of risankizumab in HIV patients with psoriasis: A case series

Exacerbation of Psoriasis Vulgaris Induced by Vaccine COVID-19 in HIV Patient: A Case Report

Risankizumab, a therapeutic alternative for psoriasis in people living with HIV

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