Development of psoriasis during therapy with an interleukin-17 inhibitor in patients with ankylosing spondylitis: case reports and literature review
https://doi.org/10.14412/1996-7012-2026-3-91-97
Abstract
Paradoxical psoriasis (pPsO) is an exacerbation or de novo development of psoriasis (PsO) during treatment with drugs that are expected to control it. It is observed in approximately 5% of patients receiving tumor necrosis factor α inhibitors and less often in those receiving interleukin-17 inhibitors (IL-17i). To date, several dozen cases of pPsO have been described during IL-17i therapy in patients with PsO and only isolated cases in patients with ankylosing spondylitis (AS).
We observed 2 patients (a man and a woman) with AS who developed three episodes of pPsO during therapy with three different IL-17i: secukinumab (SEC), netakimab (NTK), and ixekizumab (IXE). In one case, typical plaque PsO developed during SEC therapy; in another, palmoplantar pustulosis appeared 1 month after the first NTK administration and regressed after drug discontinuation. A recurrent exacerbation was observed 2 years later during IXE therapy. A pathological description of a skin biopsy specimen is presented.
The article discusses the frequency, probable causes of development, and management approaches for pPsO.
About the Authors
Sh. F. Erdes
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Shandor Fedorovich Erdes
34A, Kashirskoe Shosse, Moscow 115522
M. K. Kurbanmagomedov
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
M. M. Urumova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
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Review
For citations:
Erdes SF, Kurbanmagomedov MK, Urumova MM. Development of psoriasis during therapy with an interleukin-17 inhibitor in patients with ankylosing spondylitis: case reports and literature review. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2026;20(3):91-97. (In Russ.) https://doi.org/10.14412/1996-7012-2026-3-91-97
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