Related Experiment Video
Updated: Feb 20, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Paradoxical Cutaneous Reaction: Secukinumab-Associated PLEVA in Palmoplantar Pustulosis
Waner Liu1, Yuan Chen2, Zhimin Lin3
1Department of Dermatology, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, 518020, People's Republic of China.
None:
Palmoplantar pustulosis (PPP) is a chronic inflammatory dermatosis often treated with IL-17 inhibitors like secukinumab. Paradoxical cutaneous reactions to such biologics, though rare, are increasingly recognized. We report a case of a 25-year-old woman with PPP who developed a biopsy-confirmed acute pityriasis lichenoides et varioliformis acuta (PLEVA) eruption following six weeks of secukinumab therapy. Upon switching treatment to tofacitinib, both the PPP and the paradoxical PLEVA showed significant improvement. This case highlights PLEVA as a potential paradoxical reaction to IL-17 inhibition and suggests JAK inhibitors may be an effective alternative in this scenario.
Related Concept Videos
Hypersensitivity Reactions: Immune-Complex Reactions
Hypersensitivity Reactions: Cytolytic Reactions
Hand hygiene
Hand washing...
Allergic Drug Reactions
Hypersensitivity Reactions: Delayed Hypersensitivity Reactions
PPE Use in Healthcare Settings II: Doffing

