Clinical and histopathological characterization of eczematous eruptions occurring in course of anti IL-17 treatment: a case series and review of the literature |
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Authors: | G Caldarola F Pirro A Di Stefani M Talamonti M Galluzzo S D’Adamio |
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Institution: | 1. Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy;2. Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italygiacomocaldarola@libero.it;4. Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italyhttps://orcid.org/0000-0001-6629-9613;5. Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;6. Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italyhttps://orcid.org/0000-0002-3070-4071;7. Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italyhttps://orcid.org/0000-0002-3424-5175;8. Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy |
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Abstract: | ABSTRACTBackground: Real-life data often highlight the side effects of certain drugs not previously reported in randomized controlled trials (RCTs).Objective: To describe cutaneous inflammatory eruptions in psoriatic patients treated with an anti IL-17A agent (secukinumab or ixekizumab).Methods: Retrospective analysis of a cohort of patients with chronic plaque psoriasis who started an anti IL-17A agent between September 2016-February 2019 and who developed cutaneous inflammatory eruptions during treatment. A systematic review of similar events reported in the literature was performed.Results: Data of 468 patients were reviewed and 27 cutaneous inflammatory eruptions of 27 (5.8%) patients were collected. The eruptions appeared after a mean of 16.9 ± 17.0 weeks of therapy showing a classical acute eczema in 11 patients (40.7%), an atopic dermatitis-like rash in 11 patients (40.7%) and a psoriasiform eruption in 5 patients (18.5%). Histopathology of 12/27 cases showed epidermal spongiosis in all these variants.Conclusion: We described the clinic-pathologic features of some eczematous eruptions occurring in psoriatic patients, 3–4 months after treatment initiation with an anti IL-17A agent. Further investigations are needed to explain this phenomenon, that might be defined a paradoxical adverse event, based upon the role of IL17 in eczema pathogenesis. |
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Keywords: | Psoriasis IL17 secukinumab ixekizumab anti IL17 side effects eczematous reactions |
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