Analysis of 8 cases of acute eczematous skin adverse reactions induced by psoriasis treated with biological agents
Objective To analyze the clinical characteristics of acute eczematous skin adverse reactions induced by psoriasis treated with biological agents,and provide reference for clinical practice.Methods Eight patients with acute eczematous skin adverse reactions to psoriasis treated with biological agents at Beijing Jingcheng Skin Hospital from April 2021 to April 2023 were collected.The medical history,pathogenic process,rash manifestations,treatment outcomes,and laboratory tests were analyzed.Results All 8 cases had personal and family history of allergic diseases.The biological agents that induce skin adverse reactions include:2 cases of ixekizumab,8 cases of secukinumab,and 3 cases of guselkumab;The shortest induction time was 3 days and the longest was 56 weeks;All 8 cases showed acute eczematous dermatitis as the main manifestation.After discontinuation of biologics,1 administration of glucocorticoids,3 of cyclosporine,2 of Compound Glycyrrhizin,1 of upatinib,and 5 of abrocitinib,the rash subsided after treatment.All 8 patients showed a significant increase in the percentage of eosinophils and immunoglobulin E(IgE)in peripheral blood after the occurrence of adverse reactions compared to before.Conclusion Atopic constitution is a risk factor for skin adverse reactions caused by biological agents in psoriasis patients,so biological agents should be carefully selected.Biological agents with different therapeutic targets may induce skin adverse reactions.Returning to and maintaining immune balance can serve as therapeutic strategies.Janus kinase inhibitors such as abrocitinib may become a new treatment option.
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