Lentiginous eruption in resolving psoriasis plaques during treatment with ixekizumab: a case report and review of the literature


Submitted: 6 February 2017
Accepted: 5 September 2017
Published: 11 October 2017
Abstract Views: 1161
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Authors

We report the case of a 56-year old male with severe plaque psoriasis that was successfully treated with ixekizumab, a new anti interleukin (IL)-17 monoclonal antibody. During the first months of treatment he developed a lentiginous eruption in the sites of rapidly resolving plaques. Biopsy and immunohistochemistry reports showed elements of both lentigo and post-inflammatory hyper pigmentation. These findings, which have been increasingly described in anti-tumor necrosis factor alpha (TNFα) and anti IL-12/IL-23 therapy, may be explained by the down regulating effect of TNFα and IL-17 on pigmentation genes, which is very rapidly suppressed by ixekizumab, resulting in hyper pigmentation, and by the alteration of mesenchymal-epidermal interaction via keratinocyte growth factor during the inflammatory period, which results in the development of histopathological elements of lentigo.

Pablo Santa María, Dermatology Department, University of Chile Clinical Hospital, Santiago
Dermatology Resident
Fernando Valenzuela, Dermatology Department, University of Chile Clinical Hospital, Santiago

Assistant Professor. University of Chile

Claudia Morales, Department of Pathology, Dermopathology Section, University of Chile Clinical Hospital, Santiago
Pathology Assistant Professor
Roberto Cullen, Dermatology Department, University of Chile Clinical Hospital, Santiago
Dermatology Resident

Supporting Agencies

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Santa María, P., Valenzuela, F., Morales, C., De la Fuente, R., & Cullen, R. (2017). Lentiginous eruption in resolving psoriasis plaques during treatment with ixekizumab: a case report and review of the literature. Dermatology Reports, 9(2). https://doi.org/10.4081/dr.2017.7079

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