Atopic Dermatitis as a Paradoxical Reaction to Secukinumab in a Patient With Plaque Psoriasis

Melissa P. Zundell, Alice B. Gottlieb, Roselyn Stanger

Research output: Contribution to journalArticlepeer-review


Paradoxical reactions to biologic agents used in the treatment of psoriasis are rare but have been reported with tumor necrosis factor (TNF) blockers and, more recently, with interleukin (IL)-17A inhibitors. Secukinumab, an IL-17A inhibitor, is an effective treatment for moderate-to-severe plaque psoriasis but has been implicated in the development or exacerbation of eczematous-like reactions in rare cases. We present a patient with a history of plaque psoriasis who developed an eczematous eruption after four months of secukinumab therapy, necessitating systemic intervention for adequate control. Five months after a loading dose of dupilumab, the patient appeared in the clinic with the return of classic, thick psoriatic plaques, affecting 15% BSA. The patient declined further treatment and was subsequently lost to follow-up despite multiple attempts to contact her. This case adds to the limited, but growing body of knowledge on IL-17 blocker-induced eczematous reactions and underscores the need for careful monitoring and prompt recognition of this adverse event in patients receiving this class of drugs. J Drugs Dermatol. 2024;23(2):97-99.     doi:10.36849/JDD.7639 &nbsp.

Original languageEnglish
Pages (from-to)97-99
Number of pages3
JournalJournal of Drugs in Dermatology
Issue number2
StatePublished - 1 Feb 2024


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