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Related Experiment Video

Updated: Jun 25, 2025

Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
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Paradoxical Psoriasis.

Mariam Abdelghaffar1, Sita Kottilil2, Michael J Murphy3

  • 1School of Medicine, Royal College of Surgeons in Ireland, Building No. 2441, Road 2835, Busaiteen 228, Bahrain.

Dermatologic Clinics
|May 25, 2024
PubMed
Summary
This summary is machine-generated.

Biologic therapies for psoriasis and atopic dermatitis can paradoxically cause psoriasis (PP) and other skin conditions. Close monitoring is essential for early detection and management of these rare but serious paradoxical eruptions.

Keywords:
BiologicDupilumabInterleukin 13 inhibitorInterleukin 4 receptor alpha inhibitorParadoxical psoriasisPsoriasisTNF inhibitorTumor necrosis factor-alpha inhibitor

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Area of Science:

  • Immunodermatology
  • Therapeutic complications
  • Autoimmune disease mechanisms

Background:

  • Cytokine blocking therapies, including biologics, have transformed psoriasis and atopic dermatitis treatment.
  • A subset of patients develop paradoxical reactions to these advanced therapies.
  • Paradoxical psoriasis (PP) is a notable adverse effect, alongside other eruptions.

Purpose of the Study:

  • To highlight the occurrence of paradoxical psoriasis (PP) and other paradoxical eruptions in patients receiving biologic therapy.
  • To emphasize the need for vigilant monitoring of patients undergoing these treatments.
  • To underscore the importance of understanding the underlying immunologic mechanisms.

Main Methods:

  • Observational review of patient outcomes on biologic therapies.
  • Clinical monitoring for adverse and paradoxical events.
  • Literature synthesis on immunologic pathways.

Main Results:

  • Biologic treatments, while effective, are associated with the development of paradoxical psoriasis (PP).
  • Other paradoxical eruptions include inflammatory joint disease, inflammatory bowel disease, eczematous eruptions, lupus-like eruptions, and sarcoidal eruptions.
  • Cutaneous T-cell lymphoma is an occasional, serious complication.

Conclusions:

  • Patients on biologics require close monitoring for PP and other paradoxical eruptions.
  • Further research into the immunologic mechanisms of PP is crucial.
  • Improved understanding will enhance prediction and management of these adverse events.