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Nummular dermatitis on guselkumab for palmoplantar psoriasis
Allison Truong1, Stephanie Le2, Maija Kiuru2
1Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California.
Dermatologic Therapy
|May 10, 2019
Summary
Guselkumab therapy, used for psoriasis, may cause a rare side effect of nummular dermatitis. This previously unreported adverse event presents as distinct red, dry plaques on the skin.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Psoriasis is a chronic autoimmune skin condition.
- Guselkumab is an interleukin-37 inhibitor used for moderate-to-severe psoriasis.
- Palmoplantar psoriasis is a recalcitrant form of the disease.
Observation:
- A 40-year-old male patient with refractory palmoplantar psoriasis developed new skin lesions after initiating guselkumab.
- The lesions were well-demarcated, oval, erythematous, and asteatotic plaques on both shins.
- Histopathology confirmed chronic spongiotic dermatitis, indicative of nummular dermatitis.
Findings:
- The patient's presentation suggests a potential adverse reaction to guselkumab.
- Nummular dermatitis is a distinct clinical presentation not previously associated with guselkumab.
- This case indicates a need for vigilance regarding unexpected dermatological side effects of biologic therapies.
Implications:
- Clinicians should be aware of nummular dermatitis as a possible adverse event of guselkumab.
- Further research may be needed to understand the mechanism behind this reaction.
- This finding contributes to the broader understanding of biologic therapy safety profiles in dermatology.
