Recalcitrant paradoxical pustular psoriasis induced by infliximab:Two case reports  

作　　者：Ping Xia Yan-Hong Li Zhong Liu Xu Zhang Qian Jiang Xiao-Yong Zhou Wei Su 

机构地区：[1]Department of Dermatology,The First Hospital of Wuhan,Wuhan 430022,Hubei Province,China [2]Department of Dermatology,Midwest Center for Dermatology and Cosmetic Surgery,Clinton Township,MI 48038,United States

出　　处：《World Journal of Clinical Cases》2021年第15期3655-3661,共7页世界临床病例杂志

摘　　要：BACKGROUND Paradoxical psoriasis induced by tumor necrosis factor alpha antagonists is a rare side effect of those drugs and has similarities with and differences from classical psoriasis in clinical and pathological characteristics.Treating severe paradoxical psoriasis is challenging because the reported cases are rare,with treatment experience being only anecdotal.CASE SUMMARY We report 2 cases of paradoxical psoriasis caused by infliximab.Both cases manifested with a significant number of pustular lesions and had protracted and complicated clinical courses.In case 1,secukinumab alone could not control the eruptions,but colchicine supplementation markedly decreased disease activity.In case 2 miscellaneous medications were administered,including the systemic drug acitretin,the immunosuppressive drug cyclosporine,and the biologic agent ustekinumab.However,multiple applications of those medications failed to prevent new lesions from occurring.Both cases showed moderate-to-high antinuclear antibody titers.CONCLUSION Based on these cases,moderate-to-high anti-nuclear antibody titer seems to be a risk factor for paradoxical psoriasis.In addition,extensive pustular presentation may be a negative prognostic indicator and may portend a protracted clinical course refractory to therapy.

关 键 词：Pustular psoriasis PARADOXICAL INFLIXIMAB Secukinumab USTEKINUMAB Antinuclear antibody Case report 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]