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

Main Article Content

Pablo Santa María *
Fernando Valenzuela
Claudia Morales
Raul De la Fuente
Roberto Cullen
(*) Corresponding Author:
Pablo Santa María | psantamariahighet@gmail.com

Abstract

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.

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Author Biographies

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