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Updated: Oct 17, 2025
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
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Psoriasis induced by biological therapy
Lydia Montolio Chiva1, Àngels Martínez Ferrer1, Almudena Mateu Puchades2
1Servicio de Reumatología, Hospital Universitario Doctor Peset, Valencia, Spain.
Reumatologia Clinica
|October 9, 2021
Summary
Paradoxical psoriasis (PP) can emerge or worsen in patients receiving biological drugs, primarily anti-tumor necrosis factor-alpha (anti-TNFα) therapies. This reversible side effect often resolves upon drug discontinuation, though recurrence is possible with continued anti-TNFα treatment.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Biological drugs, particularly anti-tumor necrosis factor-alpha (anti-TNFα) agents, are widely used for chronic inflammatory diseases (CID).
- Paradoxical reactions, where a drug induces a condition it is meant to treat or a related one, are increasingly recognized with biologic therapies.
Observation:
- A multicenter case series identified 26 instances of new-onset or worsening psoriasis in patients treated with biological drugs.
- The majority of cases (93%) involved anti-TNFα agents, with adalimumab being implicated in 50% of these instances.
- A significant proportion of affected patients (81%) had no prior personal history of psoriasis, suggesting a de novo development.
Findings:
- Discontinuation of the offending biological drug led to resolution in 13 patients.
- Reintroduction of another anti-TNFα agent was associated with a higher frequency of lesion recurrence.
- Paradoxical psoriasis (PP) is a notable adverse effect linked to biological therapies, predominantly anti-TNFα drugs.
Implications:
- Clinicians should be vigilant for the development of PP in patients undergoing anti-TNFα therapy.
- Understanding the reversibility and recurrence patterns of PP informs treatment decisions and patient management.
- This highlights the complex immunomodulatory effects of biological agents and the need for ongoing pharmacovigilance.
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