Year 2024 / Volume 116 / Number 3
Letter
Infliximab-induced psoriasis in an ulcerative colitis patient successfully treated with guselkumab

176-177

DOI: 10.17235/reed.2023.9745/2023

Cong Dai, Yu-Hong Huang,

Abstract
Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract. Tumor necrosis factor (TNF) inhibitors such as infliximab (IFX) are used to treat UC. But TNF inhibitors can induce psoriasis, which was characterized by IL-17/IL-22 expressing Th17 cells and IFN-γ expressing Th1 cells, with increased expression of Th17 cells correlated with more severe skin lesions and a need for Ustekinumab (UST) therapy1. UST is a monoclonal antibody that binds to the p40 subunit of the interleukin (IL)-12 and IL-23. It has shown remarkable efficacy in psoriasis and UC2. Guselkumab, a subcutaneously administered fully human IgG1 monoclonal antibody that selectively inhibits the p19 subunit of IL-23, is approved for the treatment of patients with moderate-to-severe plaque psoriasis3. It was shown to be efficacious in patients with prior failure of other biologics such as UST and was also observed in the treatment of psoriasis localized in difficult-to-treat body regions including the scalp, palms, soles, and fingernails. We report a case of successful use of guselkumab to treat a UC patient with IFX-induced psoriasis that was refractory to UST therapy.
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References
1. Tillack, C, Ehmann LM, Friedrich M, et al. Anti-TNF antibody-induced psoriasiform skin lesions in patients with inflammatory bowel disease are characterised by interferon-gamma-expressing Th1 cells and IL-17A/IL-22-expressing Th17 cells and respond to anti-IL-12/IL-23 antibody treatment. Gut 2014; 63(4): 567-577.
2. Kolios AGA, Biedermann L, Weber A, et al. Paradoxical ulcerative colitis during adalimumab treatment of psoriasis resolved by switch to ustekinumab. Br J Dermatol 2018; 178(2): 551-555.
3. Chiricozzi A, Costanzo A, Fargnoli MC, et al. Guselkumab: an anti-IL-23 antibody for the treatment of moderate-to-severe plaque psoriasis. Eur J Dermatol 2021; 31(1): 3-16.
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Dai C, Huang Y. Infliximab-induced psoriasis in an ulcerative colitis patient successfully treated with guselkumab. 9745/2023


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Publication history

Received: 26/05/2023

Accepted: 31/05/2023

Online First: 14/06/2023

Published: 04/03/2024

Article Online First time: 19 days

Article editing time: 283 days


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