A Case of Lichenoid Drug Eruption Following Risankizumab Therapy
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Keywords
Lichenoid Drug Eruption, Risankizumab, Psoriasis, inflammatory skin disease, interleukin-23, interleukin-17, TNF-⍺ inhibitor
Abstract
Psoriasis (PsO) is a chronic inflammatory disorder that significantly impairs quality of life and is associated with numerous comorbidities. Risankizumab, a biologic therapy targeting the p19 subunit of interleukin (IL)-23, has emerged as a potent treatment option due to its ability to disrupt the IL-23/IL-17 inflammatory cascade responsible for psoriatic pathogenesis. Despite its demonstrated efficacy and safety, risankizumab’s potential for rare adverse reactions necessitates vigilant post-marketing surveillance. This case reports the first documented instance of a lichenoid drug eruption in a 79-year-old female with psoriasis following treatment with risankizumab. The reaction manifested as erythematous patches across her chest, face, neck, and calf, which improved upon cessation of risankizumab and resumption of methotrexate supplemented by narrow-band UVB therapy. This case highlights the need for ongoing surveillance of adverse side effects associated with newer biologic therapies to enhance patient management and safety.
References
2. Gordon KB, Strober B, Lebwohl M, et al. Efficacy and safety of risankizumab in moderate-to-severe plaque psoriasis (UltIMMa-1 and UltIMMa-2): results from two double-blind, randomised, placebo-controlled and ustekinumab-controlled phase 3 trials. Lancet. Aug 25 2018;392(10148):650-661. doi:10.1016/S0140-6736(18)31713-
3. Chan TC, Hawkes JE, Krueger JG. Interleukin 23 in the skin: role in psoriasis pathogenesis and selective interleukin 23 blockade as treatment. Ther Adv Chronic Dis. May 2018;9(5):111-119. doi:10.1177/2040622318759282
4. Monks G, Rivera-Oyola R, Lebwohl M. The Psoriasis Decision Tree. J Clin Aesthet Dermatol. Apr 2021;14(4):14-22.
5. Mirali S, Fabusiwa K, Linos E. Safety in numbers: risankizumab for moderate-to-severe psoriasis. Br J Dermatol. Mar 2022;186(3):394-395. doi:10.1111/bjd.20947
6. Gordon KB, Lebwohl M, Papp KA, et al. Long-term safety of risankizumab from 17 clinical trials in patients with moderate-to-severe plaque psoriasis. Br J Dermatol. Mar 2022;186(3):466-475. doi:10.1111/bjd.20818
7. Asarch A, Gottlieb AB, Lee J, et al. Lichen planus-like eruptions: an emerging side effect of tumor necrosis factor-alpha antagonists. J Am Acad Dermatol. Jul 2009;61(1):104-11. doi:10.1016/j.jaad.2008.09.032
8. Barrientos N, Garcia-Sanchez S, Dominguez JD. Letter: Lichenoid eruption induced by etanercept. Dermatol Online J. Jul 15 2012;18(7):15.
9. Gonzalez N, Patel P, Han G. A dissimilar biosimilar? Lichenoid drug eruption induced by an infliximab biosimilar. Br J Dermatol. Apr 2018;178(4):965-968. doi:10.1111/bjd.15686
10. Capusan TM, Herrero-Moyano M, Martinez-Mera CR, Freih-Fraih AW, Dauden E. Oral lichenoid reaction in a psoriatic patient treated with secukinumab: A drug-related rather than a class-related adverse event? JAAD Case Rep. Jul 2018;4(6):521-523. doi:10.1016/j.jdcr.2018.04.015
11. Murphy MJ, Cohen JM, Vesely MD, Damsky W. Paradoxical eruptions to targeted therapies in dermatology: A systematic review and analysis. J Am Acad Dermatol. May 2022;86(5):1080-1091. doi:10.1016/j.jaad.2020.12.010
12. Mylonas A, Conrad C. Psoriasis: Classical vs. Paradoxical. The Yin-Yang of TNF and Type I Interferon. Front Immunol. 2018;9:2746. doi:10.3389/fimmu.2018.02746
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