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Review
. 2024 Jul;42(3):471-480.
doi: 10.1016/j.det.2024.02.011. Epub 2024 Apr 10.

Paradoxical Psoriasis

Mariam Abdelghaffar  1 , Sita Kottilil  2 , Michael J Murphy  3 , Jeffrey M Cohen  3 , William Damsky  4
Affiliations
Review

Paradoxical Psoriasis

Mariam Abdelghaffar et al. Dermatol Clin. 2024 Jul.

Abstract

Cytokine blocking therapies have revolutionized the management of psoriasis and atopic dermatitis but can lead to the development of paradoxic psoriasis (PP). Patients treated with biologics should be closely monitored for the development of PP and other paradoxical eruptions (including inflammatory joint disease, inflammatory bowel disease, eczematous eruptions, lupus like eruptions, sarcoidal eruptions, and others) and occasionally the development of cutaneous T-cell lymphoma. Further understanding the immunologic mechanism of these processes will ultimately drive our understanding of and ability to predict and manage PPs.

Keywords: Biologic; Dupilumab; Interleukin 13 inhibitor; Interleukin 4 receptor alpha inhibitor; Paradoxical psoriasis; Psoriasis; TNF inhibitor; Tumor necrosis factor-alpha inhibitor.

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Conflict of interest statement

Disclosure There are no funding sources. M. Abdelghaffar, S. Kottilil, and M.J. Murphy have nothing to disclose. J.M. Cohen serves on a data and safety monitoring board for Advarra and has received consulting fees from Novartis. W. Damsky has received research support from Pfizer, United States, Advanced Cell Diagnostics/Bio-techne, AbbVie, United States, Incyte, United States, and Bristol-Myers Squibb, United States; receives consulting fees from Eli Lilly, TWI Biotechnology, Incyte, Epiarx Diagnostics, Bristol Myers Squibb, and Boehringer Ingelheim; and receives licensing fees from EMD/Millipore/Sigma.

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