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Updated: Jun 3, 2025
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
38.9K
Breakthrough Psoriasis in Patients Receiving Biologicals
Thomas Damsin1, Gilles Absil1, Florence Libon1
1Department of Dermatology and Venerology, CHU of Sart Tilman, University of Liège B-4000, Liège, Belgium.
Psoriasis (Auckland, N.Z.)
|January 9, 2025
Summary
Breakthrough psoriasis is rare in patients on biological therapy, occurring in about 1.13% of cases. These rare events are typically triggered by the Köbner phenomenon or severe psychological stress, not treatment timing.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Biological therapies effectively manage moderate-to-severe psoriasis, offering long-term safety.
- Despite stable disease or remission, some patients on biologicals experience sudden psoriasis flares.
Purpose of the Study:
- To prospectively investigate the clinical characteristics of breakthrough psoriasis in stabilized patients on biological therapy.
- To describe triggers, rescue therapies, and outcomes of sudden psoriasis flares during biological treatment.
Main Methods:
- A 5-year prospective follow-up study included 985 psoriasis patients achieving PASI 90-100 on biologicals.
- Clinical features of breakthrough psoriasis, rescue treatments, and outcomes were documented.
Main Results:
- Breakthrough psoriasis occurred in 1.13% (10/882) of patients over 5 years.
- Triggers identified were Köbner phenomenon (2 cases) and severe psychological stress (8 cases).
- Rescue therapies included potent topical corticosteroids or additional biological injections; two patients improved after stress resolution.
Conclusions:
- Breakthrough psoriasis is an exceptional event in biologically treated, stable psoriasis patients.
- Events are linked to Köbner phenomenon or severe psychological stress, potentially via immunomodulation.
- No specific biological agent or dosing schedule was implicated.
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